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Author Topic: chances of getting Ols  (Read 1954 times)

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Offline meltonex

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chances of getting Ols
« on: December 31, 2016, 10:53:32 pm »
Sorry to revive a slightly older thread - but I was looking at the site referenced in this thread:

http://i-base.info/ttfa/section-1/12-cd4-count-cut-offs-and-the-risks-of-opportunistic-infections/

And it says the risk of TB is higher at any CD4 count.

I am a bit confused why this would be? If your CD4 count is the same as a healthy individual shouldn't your risk of catching TB be the same?

Or is this potentially trying to warn people that if you get Tuberculosis while at a high CD4 count it could live latently and potentially impact you if your CD4 drops?
« Last Edit: January 01, 2017, 03:19:10 am by JimDublin »

Offline Ptrk3

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Re: Re: chances of getting Ols
« Reply #1 on: December 31, 2016, 11:15:32 pm »
Not to worry, meltonex.  My bet is that it is a statistical thing, not an individual thing, not a "cause and effect."  In other words, people worldwide who have HIV may be at more risk of contracting TB (or are already harboring TB) than those that are HIV negative.  Sometimes statistics are just that, no more--a "group" thing rather than an "individual" thing.

If there a message to be taken from this, I would presume that the message would be that if you live an area where TB is more prevalent than other areas, you may wish to be more vigilant of TB if you are HIV positive regardless of your CD4 count.
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Offline Jim Allen

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Re: chances of getting Ols
« Reply #2 on: January 01, 2017, 04:54:18 am »
Hi Meltonex,

How is you BF doing? its been a while since you last update.
Why the sudden interest of worry about OI? Might give us some context as well to  what your looking for.

But yeah I agree with Patrick and as pointed out TB can happen statistically to anyone, even HIV negative people.  Look your BF is on treatment right? so benefits of early treatment and continuing treatment are decreasing the risks of certain HIV-related health problems that can sometimes occur in people even with high CD4 counts including tuberculosis. It does not mean no risk, but don't panic as Patrick said he belongs to a group of people who generally speaking have an immune system challenges (to say it nicely) so statistically across that group things will stand out, but that does not mean it directly applies/correlates to your BF as a single individual.

Anyhow hope all is well?

Jim

« Last Edit: January 01, 2017, 05:33:37 am by JimDublin »
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Offline CaveyUK

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Re: chances of getting Ols
« Reply #3 on: January 01, 2017, 08:45:42 am »
My reading of it is - The risks increases that article refers to, is for CD4's at any count for *untreated* HIV.

At the end of the article it states :

* CD4 count increases after starting ART, often means your immune system can deal with these infections by itself.
* After CD4 inncreases on ART, treatment to prevent OIs can often be stopped.

Yes TB can affect anyone, and HIV can complicate this an increase the risk of manifesting itself (remember that OI's by definition, are bugs that people get but usually can deal with it via their own immune system). Someone could have a sky high viral load which the body is busy fighting and yet a 'healthy' CD4 count - in some parts of the world where TB is prevalent, there may still be policies in place to only start ART at lower CD4 counts (such as 350), which is why information like this is extremely relevant. It also is key information for people who travelled from areas where TB is endemic and are not yet on full treatment.

The risk of OI's reduces at higher CD4 counts but is *drastically* reduced when the virus is fully suppressed under antiretroviral treatment AND you have a higher CD4 count. I'd go as far to say that If you (or your BF) is on ART, has reached undetectable levels and has a CD4 count in 'normal' range, then you really should not spend any time worrying about serious OI's at all.
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Offline meltonex

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Re: chances of getting Ols
« Reply #4 on: January 01, 2017, 11:18:28 am »
Thanks for the responses - the context is that we travel a lot and will be going to Vietnam this year where they have a much higher rate of TB.

So based on the responses I would say the worry should be quite low, my boyfriend is on treatment - has been within a few months of contracting HIV. He has never had a CD4 count lower than around 600 and has been undetectable since starting treatment.

Thank you all for your advice!

Offline Ptrk3

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Re: chances of getting Ols
« Reply #5 on: January 01, 2017, 12:15:54 pm »
You're welcome.  With your boyfriend's high CD4 count and his having an undetectable viral load, he will be fine.  Safe travels to you both when the time comes!
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