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Author Topic: Intro phaelbr - Viral load / CD4  (Read 821 times)

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Offline phaelbr

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Intro phaelbr - Viral load / CD4
« on: June 22, 2020, 11:13:08 pm »
Hello everybody,
I’m from Brazil. I was diagnosed one month ago. First I had a gums infection earlier this year that only got away with antibiotics. On may 3rd I started vomiting and having 24/7 fever. One week has passed, I went to the only doctor available during covid in town, he gave me antibiotics, lots of stuff to the tummy. One week later, nothing happened. Through some contact my mom was able to schedule an appointment with an endocrinologist (my insurance issued a decree that only emergencies should be dealt with). He didn’t do anything, he said I had to go to an infectologist, but that same day I had to go to the only hospital not treating corona, as I had fever he had to alert the authorities. At this time I thought I had hiv already. 2h for the triage, 2 hours waiting and five hours inside. It was hell. Since my hiv exams were taking longer than all the others (negative) I went to the public clinic and got the fast one. I cried a lot, I still live with my mom and she was with me. So the doctor wrote a letter to her residency professor, who’s the director of the aids thing for the next city.  He sent me straight to the lab, to have a TB test, CD4 and viral load, and an endoscopy with biopsy. The endoscopy messed up my oesophagus and I couldn’t eat. After my first consultation I started with umarato de tenofovir desoproxila + lamivudina and dolutegravir sódico.  I couldn’t eat cuz it hurt my oesophagus, I had candida and when the biopsy came out I had herpes. The medicine made me sick the whole time. Since I couldn’t eat I spent 5 days at the hospital.
Back home I started eating a lot, even during the night.
But after my last appointment, with the results of the CD4 and viral load, the medicine ended the binge eating. Fortunately, I’m gonna change it next week. I’m allergic to Bactrim.
Every week I have something different: gastrites week, reflux week, painful nodules week that made me cry of pain, now apparently is fever week with reflux week.


My biggest question is:
The doctor refuses to tell me how long I’ll get from a CD4 of 25 to above 200. At first I thought by the end of the year, but then on google images I saw that studies showing graphs with 2 or more years.
What I wanted to ask you guys, so I could have an idea of how long my house arrest will last (I think they’ll eradicate covid before I get to 200 CD4) is:

What was your inicial viral load and how long did it take to be undetectable. (Mine is 1 million)
What was your inicial CD4 and how long did it take to reach an acceptable level. (Mine is 25)


Thanks for listening.
« Last Edit: June 23, 2020, 06:04:26 am by Jim Allen »

Offline Jim Allen

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Re: Intro phaelbr - Viral load / CD4
« Reply #1 on: June 23, 2020, 05:09:00 am »
Hiya,

Sorry to hear about the diagnosis but welcome to the forum.

Sounds like you are having a rough time, the endoscopy procedure can indeed be rough but this will heal and the candidiasis can be treated.

The Bactrim plenty of us can speak to our experiences, all ill say is it can be really hard on a body and stomach issues would be fairly common experience, although absolutely necessary and your doctor can switch you if you are allergic, the thing to keep in mind is the antibiotics is not something you will need permanently.

Asides from the antibiotics, it would not be totally uncommon to feel worse before starting to feel better, with a very low CD4 count. As the virus starts to be suppressed by the HIV meds and the immune system start to rebound and starts healing or fighting things it had ignored so far you can feel worse, it does get better, just keep your doctor informed about any development.

My Viral load was several times yours. Anyhow how long it takes to get to a suppressed VL? - Depends on a lot of things.

Some people after starting treatment get there within 2-3 months, others take 6-12 months.

Quote
How do I know my treatment is working?
When HIV drug therapy is started—preferably with a powerful combination of drugs—the level of HIV should start to drop dramatically. This is where viral load testing comes in. During the first two months of therapy, an HIV-positive person’s viral load should drop a minimum of 90 percent. In other words, someone who starts treatment with a viral load count of 100,000 should drop to 10,000 or less within two months. Within 4 to 6 months of starting therapy, the viral load should have dropped a lot more, hopefully below the level of the viral load test’s sensitivity (“undetectable”). Sometimes undetectable means a count less than 200 or 400, but most tests used today can detect as few as 20.

How long does it take for the CD4 count to reach 200?

These counts depend on a lot of things, age, sex, length of the infection, the damage that was done. Could be less than a year or it could several years.

Once the virus is suppressed and if you have the antibiotics it's already somewhat less of a concern and the journey will have started towards the 200. 

Quote
As for your CD4 cell count, you will likely see an increase between 100 and 200 cells in the first 12 to 18 months, and can gradually climb from there as long as viral load remains undetectable. Some people who start HIV treatment for the first time have a poor CD4 response despite achieving and maintaining an undetectable viral load. Researchers refer to individuals in this situation as “discordant responders.” Most discordant responders waited to start treatment until their CD4 counts were well below 200. This is one of the reasons that the guidelines recommend starting ARVs earlier.

Look take it easy and I've included some information next to my answers from the POZ lessons, perhaps when you are ready have a read of these easy to digest lessons.

Keep us posted.  ;)

Best, Jim

https://www.poz.com/basics/hiv-basics/starting-hiv-treatment
https://www.poz.com/basics/hiv-basics/newly-diagnosed
« Last Edit: June 23, 2020, 06:04:38 am by Jim Allen »
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Offline Loa111

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Re: Intro phaelbr - Viral load / CD4
« Reply #2 on: June 24, 2020, 05:56:53 am »
Hi, Sorry to hear about your diagnosis. It's not easy at the beginning.

As Jim said, for your CD4 to increase to 200, it depends on many factors and is very different for each person. For me it took almost 2 years to go from CD4 22 up to over 200 (just a few months ago), and even at that, I still had to take to antibiotics for a few more months until doctors were sure I was staying over 200. . It is not a race though, and all you can do to help yourself recover is to take your medicine daily, and live healthy. CD4 will recover in time. I wasted a lot of time worrying trying to will my CD4 to increase faster....that did not work! lol.

You will get great support from everyone on this forum and lots of info so keep visiting and posting your updates .Good luck on recovery :)

Offline JosephP

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  • Keep looking FORWARD... Dx'd 8/10/2013...
Re: Intro phaelbr - Viral load / CD4
« Reply #3 on: June 25, 2020, 09:59:32 pm »

My biggest question is:
The doctor refuses to tell me how long I’ll get from a CD4 of 25 to above 200. At first I thought by the end of the year, but then on google images I saw that studies showing graphs with 2 or more years.
What I wanted to ask you guys, so I could have an idea of how long my house arrest will last (I think they’ll eradicate covid before I get to 200 CD4) is:

What was your inicial viral load and how long did it take to be undetectable. (Mine is 1 million)
What was your inicial CD4 and how long did it take to reach an acceptable level. (Mine is 25)


Thanks for listening.

Hiya... Sorry for your diagnosis, but you are in the right place to vent and ask questions. As far as your ascent from 25 to over 200, it really depends on several factors including, but not limited to, genetics as my ID doctor indicated. I, fortunately crossed the 200 mark in three months (mind you that my CD4 count was 198) and has been climbing ever since. I was UD after three months on Stribild. I was put on Bactrim for over 18 months even after surpassing 200. So, don't get discouraged and fixated on how fast the change occur but rather that the change is occurring! Good luck. And here we are to support each other..
Today January 20, 2020, I have taken 2378 pills of my ARV since first pill. This means 79 bottles of 30 pills of ARVs at an average of $3950 per bottle or $313,103 USD for my treatment. I have a compliance of 99.83% taking my meds and only .17% (or 4 pills) non-compliant. Of these four pills two I forgot completely, One I lost and one I didn't have with me while traveling! I became UD 3 months after treatment start   ***We are all dealing with this. And we will live long and productive lives!! AND, yes the Lord is my shepherd. Life is good... And thanks for the meds! ***

Offline Almost2late

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Re: Intro phaelbr - Viral load / CD4
« Reply #4 on: June 26, 2020, 01:00:16 am »
Olá Phaelbr,

Sorry about you catching this virus, but now that you are getting care and on medication, you will do well.

When I was diagnosed 6 yrs ago, I had a cd4 of 13 and it took me a little over 2 years to get over 200, and about 1 and a half years to reach undetectable. I'm on the same HIV medication as you, it's good stuff.

My advise to you is if you're a heavy drinker, slow down.. if you smoke, quit.. eat healthy, like fruits, vegetables, yogurt.. exercise ... and get good sleep.

And if you have any questions, come in here man, just like you did in this first post.. ask away. Good luck
"Hang on to your hopes my friend..
thats an easy thing to say,
but if your hope should pass away,
simply pretend that you could build them again"...

Offline Pirata

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Re: Intro phaelbr - Viral load / CD4
« Reply #5 on: June 27, 2020, 07:45:16 pm »
Hope you are doing better. CD4 count is different for everybody. I started my treatment with 100 CD4, and after a year, last February was my last lab, I was at 160. Others have a faster process. One thing I have learned is focus on being undetectable, that is what is going to help you to do better. One more thing, the doctor changed me to Dapson, because he said it affects the CD4 less.

Offline harleymc

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Re: Intro phaelbr - Viral load / CD4
« Reply #6 on: June 27, 2020, 09:09:36 pm »
Of course your doctor won't lie to you and give you a guaranteed time line to having more than 200 cd4s.  That would unthical and your doctor could be struck off the medical register if he or she did so.

So let's consider that many peoples' counts bounce back within a year or two.  Other people like myself take over six years.

You came for reassurance so here's your free dose of anxiety.  HIV is a messy process. Wanting to hear happy news all the time exposes you to things you don't want to hear.

Offline JosephP

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  • Posts: 318
  • Keep looking FORWARD... Dx'd 8/10/2013...
Re: Intro phaelbr - Viral load / CD4
« Reply #7 on: June 27, 2020, 10:19:50 pm »

You came for reassurance so here's your free dose of anxiety.  HIV is a messy process. Wanting to hear happy news all the time exposes you to things you don't want to hear.

Man, that couldn't be any closer to the truth, even if Dr. Fauci would have said it! :) :) :)
Today January 20, 2020, I have taken 2378 pills of my ARV since first pill. This means 79 bottles of 30 pills of ARVs at an average of $3950 per bottle or $313,103 USD for my treatment. I have a compliance of 99.83% taking my meds and only .17% (or 4 pills) non-compliant. Of these four pills two I forgot completely, One I lost and one I didn't have with me while traveling! I became UD 3 months after treatment start   ***We are all dealing with this. And we will live long and productive lives!! AND, yes the Lord is my shepherd. Life is good... And thanks for the meds! ***

Offline kentfrat1783

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Re: Intro phaelbr - Viral load / CD4
« Reply #8 on: June 28, 2020, 09:15:52 am »
Hi,

Sorry about your Dx but when I was diagnosed back in 2017 this is the forum that helped me get through my new life.  I really appreciated everyone's honesty and being frank when I asked questions. 

In relation to when you will get your CD4 over 200...well only time will tell.  I started at "2" and was about 2.5 years later before I got over 200.  My specialists stopped talking about me getting over 200 as I started so low and wasn't progressing much. 

All the Rx's do is to get the viral load down (preferably undetectable) so your body can re-generate your CD4's. 

I was also on Bacterium from the start and from points made my stomach upset but was my specialist still encouraged me to take it as the alternative option wasn't as good.  For a bit, I only took it every other day (specialist recommended) and after a few months, I was able to go back to it daily.  I also learned to reduce the number of bread I ate as that seemed to upset my stomach ever more.  Listen to your body when your stomach is upset and I bet you can do a few things to improve it.

The biggest piece of advice I could give you is to be totally honest with your doctors.  If you have a question then ask.  Something feels different then ask.   There may be no connection but it sure helps my peace of mind.  Also, if you haven't done it yet set up a daily reminder on when to take your pills.  People today have so many reminders set and phone notifications so no one will even know what it is about. 

Take care and wishing you the best.  You too will make it through this.

Kenneth
06/08/2020 - CD4 257 (20%) VL <20
03/17/2020 - CD4 285 (19%) VL 101       (2.00)
09/17/2019 - CD4 218 (16%) VL (?)
06/18/2019 - CD4 173 (16%) VL <20
03/13/2019 - CD4 170 (16%) VL <20
January 2019 - Started Triumeq
12/05/2108 - CD4 174 (18%) VL <20
08/28/2018 - CD4 166 (15%) VL <20
05/08/2018 - CD4 106 (11%) VL <20
03/05/2018 - CD4   90 (10%) VL <20
12/11/2017 - CD4   60 (  8%) VL ?
09/07/2017 - CD4   42 (  6%) VL  54        (1.70)
May 2017 - Started Atripla
05/11/2017 - CD4     2 (  1%) VL 169,969 (5.23)
OI's: PCP
Dx`d May 11, 2017
Location: USA

Offline virgo313

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Re: Intro phaelbr - Viral load / CD4
« Reply #9 on: June 28, 2020, 11:34:06 am »
Same here, Bactrim is nasty. Have to rush for toilets a lot. Rashes too. But I knew I have to take it to fend off OI. As for CD4, my Dr have not test them for almost 2 yrs now, not needed anymore. My last count was at 475. As for VL, I will be tested only once a year. Most important result I need to know is that I am UD.

Last week, have my half yearly Dr appointment. Dr suggest to continue my appointment at a clicnic near my home saving travelling time to hospital.
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

 


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