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Author Topic: UD but low CD4  (Read 564 times)

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Offline Will2015

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UD but low CD4
« on: December 19, 2018, 03:51:58 am »
Hi, I'm writing this for a friend. He's 26yrs old, poz for 20 years... He changed his tratement one month ago because he has not been UD for roughly 1-2 years. He had Cd4s at 300-400 al vl constantly 200--600...

His new treatment is Tivicay + Kivexa. Now, after one month with the new stuff he's UD but his CD4s are at a record low of 170. He never had them this low. He will begin taking some prophilaxy meds but he's totally confused of Wtf is going on...

Any help to clarify this will be highly appreciated!

Offline JimDublin

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Re: UD but low CD4
« Reply #1 on: December 19, 2018, 04:18:35 am »
Hiya

His old regime was not suppressing the virus, he switched to something that will.
That should be your friends focus.

I get that it might be disconcerting if the CD4 count goes down on treatment or during switching treatment but its only a snapshot moment and might not be a real result at all. He's only just reached suppression of the virus after 2 years of low level viral load, so give the body time to sort out his CD4 cells and keep in mind his HIV meds don't do anything to for or against CD4 counts directly.

What was the % like? Overall the thing to keep in mind is that CD4 counts can, will and do fluctuate all the time for numerous reasons and a single snapshot moment is not worth the stressing. Things like having a recent cold, flu or fever, smoking, late night (Lack of sleep), time of day, fatigue all seem to make them temporary jump around the place.

Tell you friend not to worry, the antibiotics is only temporary and that if he needs support here, he is more than welcome to create his own account.

We don't bite  :)

Jim
« Last Edit: December 19, 2018, 04:31:05 am by JimDublin »
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Offline Will2015

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Re: UD but low CD4
« Reply #2 on: December 19, 2018, 06:05:55 am »
Hi Jim thank you very much for the nice detailed answer. Helps a lot, really to calm things down. His cd8s were 955 and the ratio is 0.19 ... I have no idea however how does that offer a clearer picture of the immune system...

Again, many thanks! :)

Offline JimDublin

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Re: UD but low CD4
« Reply #3 on: December 19, 2018, 07:38:18 am »
I would give you a similar answer as i did for the CD4's although I admit more could be said about CD8's however its not relevant.

Look the average HIV negative person will have a CD8 ratio between +- 0.9 and 2, CD4 count between 400-1500, and a CD4 % around 25-30% to 60's %.

However its not a measurement of health, neither does it indicate how well those cells are working. Your friends treatment has not been suppressing the fully for the past 2 years, he only just switched and reached UD a short time ago.

Variances in numbers are to be expected. Looking at a trend over time tends to be more insightful, yet equally useless. He could talk to his doctor for reassurance if he is really worried however if it was me I would keep taking my meds and antibiotics, not be stressing about it.

No amount of stressing will change it and a single snap short moment is hardly worth loosing sleep over.  :) I would be telling him to give his body time, get a few more rounds of labs in over the next year and see where the trend goes over time.

I'm sure others on the forum could explain it a lot better but I hope my two cents somewhat helps.

Jim

« Last Edit: December 19, 2018, 07:43:06 am by JimDublin »
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Offline Will2015

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Re: UD but low CD4
« Reply #4 on: December 19, 2018, 10:05:47 am »
Many thanks Jim for the awesome answer :) Honestly I was stressing more than my friend. He's a super cool guy and it's a shame he has this virus since childhood. I sent him all your replies and also told him about this awesome helping community :) You are totally right about what you said.

Offline JimDublin

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Re: UD but low CD4
« Reply #5 on: December 19, 2018, 10:23:24 am »
Well glad it helped, and it sounds like you are both very supportive of each-other.
Nice to see that.  :)

Jim
HIV 101 - Everything you need to know
HIV 101
Transmission and Risks:
HIV Transmission and Risks
Read more about Testing here:
HIV Testing
Read about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read about HIV prevention here:
HIV prevention
Read about PEP and PrEP here
PEP and PrEP

Offline JimDublin

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Re: UD but low CD4
« Reply #6 on: December 19, 2018, 03:22:37 pm »
I shouldn't, but ill ask anyway...

2 years with a VL nearing 600 range, did he have or develop any resistance? Or simply a case of not reaching UD for unknown reasons?

Jim
HIV 101 - Everything you need to know
HIV 101
Transmission and Risks:
HIV Transmission and Risks
Read more about Testing here:
HIV Testing
Read about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read about HIV prevention here:
HIV prevention
Read about PEP and PrEP here
PEP and PrEP

Offline Will2015

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Re: UD but low CD4
« Reply #7 on: December 20, 2018, 03:43:25 am »
Hi Jim, he also has hep B and his doctor for some unexplained reason simply took way too much time to change its treatment because his Cd4s were constantly hovering around 300-400 despite not being UD... Anyway he's chill and cool now and he'll repeat the tests in one month....

Happy holidays!

Offline JimDublin

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Re: UD but low CD4
« Reply #8 on: December 20, 2018, 04:18:59 am »
Thanks. Happy Holidays to you and your friend.

Jim 
HIV 101 - Everything you need to know
HIV 101
Transmission and Risks:
HIV Transmission and Risks
Read more about Testing here:
HIV Testing
Read about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read about HIV prevention here:
HIV prevention
Read about PEP and PrEP here
PEP and PrEP

Offline Mightysure

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Re: UD but low CD4
« Reply #9 on: December 20, 2018, 01:18:05 pm »
It will take time since he went for a significant time with low level viral replication. Cd4 raw numbers can fluctuate, the percentage is a more stable indicator of immune health.

And with a cd8 that high, there may be a lot of imflammation, relatively speaking, that the body needs to recover from.

As a friend, try to get him to focus on the positive things, e.g. his UD status and not stress out about his numbers not improving as fast as others. Stress never helps.

 


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