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Author Topic: venom_X - Introduction thread  (Read 375 times)

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Offline venom_X

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venom_X - Introduction thread
« on: August 12, 2019, 03:41:22 pm »
Hi

I just test positive a couple of months ago and I'm not sure what the route of transmission is. I can only connect it to a medical procedure done outside U.S. that fits into the time frame of potential transmission

Here's a brief summary:

Day ~ -60: Forth generation Ag/Ab test negative during annual physical in U.S.

Day 0: Did a minor out-patient surgical procedure at a clinic outside of U.S.

Day 14: Onset of acute symptoms: fevers starting at 100.4f going all the way to 103.5

Day 15: Since I was on this forum before seeking prevention strategies, I was aware of the acute symptoms, when the fever didn't go away after repeated Tylenol dosage, I became concerned. Tested with Alere hiv combo test, both Ag and Ab negative

Day 16: Fever is not getting better, extremely worried, observed oral thrush, ARS rash starts to appear on face and upper body. Went to hospital ER, requested RNA and 4th gen test, started ART preemptively, 2 weeks post infection

Day 19: HIV RNA came back positive, 4th gen Ag came back positive, 3rd gen Ab negative, continue ART

Day 24 (5 days post start of ART): First test of quantitative viral load and CD4. VL: 330k, CD4 400 (33%), CD8 460, CD4/CD8 ratio: 0.9; total white count: 4500, Neutrophils: 2300 (near the low normal range)

Week 4.5 (2.5 week post start of ART): VL: 300, CD4: 500 (30%), CD8: 690, ratio: 0.7, white count: 6600, Neutrophils: 4500

Week 7.5 (5.5 week post start of ART): VL: 30,  CD4: 590 (28%), CD8: 920, ratio: 0.6, white count: 4500, Neutrophils: 2000 (near the low normal range)

Have a couple of questions:

(1) Why are the CD4 percentage keeping on dropping even with effective viral replication control

(2) Why are the CD8 continuously expending and thus the CD4/CD8 ratio is dropping

(3) What to take on the up and down of the total white count and Neutrophils even on treatment, with the last VL being 30 and still Neutrophil counts dropped significantly since last measurement

Overall, does the combined expended CD8 and dropping CD4 percentage and CD4/CD8 ratio, and Neutrophils count indicate problems with immune reconstitution while on treatment? 

Thanks so much for your insight!
« Last Edit: August 12, 2019, 04:54:21 pm by Jim Allen »

Offline virgo313

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venom_X - Introduction thread
« Reply #1 on: August 12, 2019, 04:39:40 pm »
Hello Venom,

Your numbers are good. How are you feeling now after dx and on meds?
« Last Edit: August 12, 2019, 04:54:35 pm by Jim Allen »
RVD Nov 2015. VL --> Log 5.32 HAART on 23/11/15
TDF+FTC+EFV / Chemo KS - 25/11/15 - 20/01/16.
CD4 - 4 (3/11/15) / VL - 225,000   ~ CD4 - 65 (7/03/16) / VL - UD
CD4 - 153 (8/09/16) / VL - UD (20) / CD4% -6%   ~   CD4 - 215 (11/03/17) / VL - No Result / CD4% -8%
CD4 - No Result (10/04/17) / VL - UD (20)   ~   CD4 - 455 (11/05/18) / VL - UD / CD4% -14%
CD4 + CD4% (18/10/18) - Dr not going to  do this anymore / VL - To test only yearly. This Sucks..!
CD4 - 472 (10/04/19) / VL - UD / CD4% - 42%

Offline Jim Allen

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Re: venom_X - Introduction thread
« Reply #2 on: August 12, 2019, 05:07:19 pm »
Hiya

Sorry to hear about the reactive results. So you tested negative 60 days before a procedure meaning 150 days before the procedure you did not have HIV.

I don't understand though why you are running nearly bi-weekly CD4/CD8 tests? What's the goal with that? If I ran a CD4/CD8 test over any person HIV positive it would vary strongly, that's normal and your CD4 count is within a normal range the CD8 slightly out.  As for the meds & VL  you have only just started to suppress the virus, give your body time.

What ART meds have you started taking and, have you set up an appointment with an ID doctor?

Best, Jim
« Last Edit: August 12, 2019, 05:13:05 pm by Jim Allen »
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 venom_X

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Re: venom_X - Introduction thread
« Reply #3 on: August 12, 2019, 06:14:22 pm »
Hi virgo I知 doing OK now. No other side effect or symptoms so far other than low fevers every afternoon that rises to 99.5. Emotionally still asking myself why me how it all happened. Incredulous as to how I can get infected this way.


Hi Jim thanks for your reply. I知 worried about the rising CD8 count and percentage . I read that it should slowly decrease with treatment and higher number indicates worse outcomes. Thus was curious if anyone else has seen such trend during their treatment.

I知 in a clinical study evaluating ART impact initiated during acute infection thus the frequent labs. I知 on Biktarvy and has tolerated it well.


Offline daveR

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Re: venom_X - Introduction thread
« Reply #4 on: August 12, 2019, 09:19:18 pm »
I use to be concerned about my CD8 count and CD4/CD8 ratio. My Doctor doesn't even check that number, I use to go to a separate clinic and get it done. CD8 count always high and my ratio a bit low. I use to worry about it so I asked my Doctor why she did not check it. She said to her it was unimportant, as long as my CD4 count was good I need not worry as there is nothing they could do to change the ratio. Basically it is what it is. I stopped having mine checked, saved myself some money.
From what I have read, undetectable or not, the body knows there is something in you that should not be there and mounts a defence, it does not know that the meds are controlling the virus, it does what it is supposed to do.
I have to adopt the philosophy of if I can't control it, I can't worry about it.

Dave

Offline Jim Allen

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Re: venom_X - Introduction thread
« Reply #5 on: August 12, 2019, 11:54:09 pm »
Hi Jim thanks for your reply. I知 worried about the rising CD8 count and percentage . I read that it should slowly decrease with treatment and higher number indicates worse outcomes. Thus was curious if anyone else has seen such trend during their treatment.

I知 in a clinical study evaluating ART impact initiated during acute infection thus the frequent labs. I知 on Biktarvy and has tolerated it well.

Hiya,

Well, your CD8 count is within the average range, same as your CD4 counts. I.e it's within the average range for HIV negative population.  As for the ratio, the normal range for the CD4:CD8 ratio is between 0.9 and 1.9 so your slightly low not high at the moment on that front.

Here is the thing, you can't change it. ART does not directly change any of this either, ART simply suppresses the virus so it can't unchallenged continue to do measured & unmeasured damage to you, the rest is up to your body/immune system and takes as much time as it takes so there is not much point focusing on these number or stressing about them.

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 virgo313

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  • Posts: 184
Re: venom_X - Introduction thread
« Reply #6 on: August 13, 2019, 12:35:29 am »
Hi Venom,

My thinking is same as DaveR, that痴 why my reply to you was just to ask how you feel. Trying to 電ivert from the topic of all those 渡umbers/readings.

As other has replied, other readings does not matter. Just the VL and CD4 will do.
Most important is that you are feeling ok. Mind is positive thinking being Poz.
Tks
RVD Nov 2015. VL --> Log 5.32 HAART on 23/11/15
TDF+FTC+EFV / Chemo KS - 25/11/15 - 20/01/16.
CD4 - 4 (3/11/15) / VL - 225,000   ~ CD4 - 65 (7/03/16) / VL - UD
CD4 - 153 (8/09/16) / VL - UD (20) / CD4% -6%   ~   CD4 - 215 (11/03/17) / VL - No Result / CD4% -8%
CD4 - No Result (10/04/17) / VL - UD (20)   ~   CD4 - 455 (11/05/18) / VL - UD / CD4% -14%
CD4 + CD4% (18/10/18) - Dr not going to  do this anymore / VL - To test only yearly. This Sucks..!
CD4 - 472 (10/04/19) / VL - UD / CD4% - 42%

 


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