Re: Can you explain low CD4 counts at a low viral load? more inf

[Guest guest]

Don't get too hung up on your counts. Have been alive for 24 years now with

a CD4 count that has fluctuated between 11 and 460. Take care of yourself,

don't party too much and decide to stay alive. You'll be fine.

>

>To: PozHealth

>Subject: Re: Can you explain low CD4 counts at a low viral

>load? more info

>Date: Sat, 12 Aug 2006 09:28:43 -0000

>

>

>Truly fascinating. The discordant piece in your situation is that your

>T4 numbers are so very low 257-263 and 17.1% - 18%. This is not typical

>of people with a strong immune response to HIV. If you are truly in the

>category of people whose immune system can control HIV your T4 numbers

>should rise back to normal over time.

>

>Since it is a strong possibility that you have Subtype E HIV, most

>common in Thailand, there is still a question how reliable viral load

>tests are - since the tests were not designed for Subtype E and there is

>a known question about reliability with this Subtype. If your virus

>hasn't been typed in the lab to determine if it is Subtype E, I think it

>might help answer what is really going on.

>

>The progression of Subtype E HIV is also somewhat different. This is a

>presentation regarding the progression of patients in Thailand with

>Subtype E virus from the 2001 Conference on Retroviruses and

>Opportunistic Infections.

>

>http://www.retroconference.org/2001/posters/207.pdf

><http://www.retroconference.org/2001/posters/207.pdf>

>

>You'll notice (on Slide 14) that for some reason, in these people

>studied, survival with Subtype E HIV takes a big decline around 8 years

>after infection. For some reason, survival with Subtype E is not as

>favorable as Subtype B, although those with Subtype E virus and low

>viral load have a dramatically better survival history. The treatments

>which are most effective for Subtype E are also somewhat different. So

>typing your virus would be important if you haven't already done so.

>

>I have a friend in Sweden who has a very high level of T Regulatory

>Cells (T4) and CNAR T8 cells. He has been HIV+ for six years. Initially,

>his viral load was around 25,000 and his T4 numbers were 550 and 26%.

>

>But without drugs and not needing Interleukin-2, since his TReg and CNAR

>was already high, his viral load is now 1,100 and his T4 numbers are 980

>and 35%. Studies of prostitutes in Africa who are HIV negative, yet

>probably exposed to HIV on a daily basis, have even higher levels of T

>Regualtory Cells and CNAR T8 cells - these are your immune system's key

>to controlling HIV. So if you have the option of doing so, you could

>also measure your percentage of T Rregulatory cells - CD4+/CD25+ is a

>good approximation.

>

>

>

> > >

> > >

> > > Healthyseed found this " Question and Answer " from UCSF, which

>appears to

> > > explain his paradox of an abnormally low viral load test results

>with

> > > sub-type E HIV.

> > >

> > > Can you explain low CD4 counts at a low viral load?

> > >

> > > May 16, 2000 -- Answered by ce Peiperl, MD, HIV InSite Medical

> > > Editor

> > > http://hivinsite.ucsf.edu/insite?page=ask-02-02

> > > <http://hivinsite.ucsf.edu/insite?page=ask-02-02>

> > >

> > >

> > > Question: My friend was diagnosed with HIV in 1995. At that time,

>his

> > > CD4+ count was about 900/mm of blood and viral load approx. at 9,000

> > > copies/ml. He stayed at this CD4+ level for a couple of years, while

>his

> > > viral load went down to about 3,000/ml. In 1998, his T-cell count

>took a

> > > downward plunge at was at 69CD4+/mm. His viral load grew to 6,000

> > > copies. Last month, the results of Tcell and viral load tests were

>CD4+

> > > at 34/mm and viral load at 11,000/ml. His doctor isn't certain why

>this

> > > (viral load), historically has been low.

> > >

> > > He has never taken antiretrovial medications, to date has not had an

> > > opportunistic infection, but several years before, was tested + for

>HBV.

> > > Is there an explanation for this situation? I am an HIV community

> > > educator and do a great deal of research to keep myself up to date

>(as

> > > much as possible). I have been unable to find info on my friend's

> > > situation. What is his prognosis? Can you help?

> > >

> > >

> > > Answer: It is not that unusual to have low CD4 counts at a

>relatively

> > > low viral load. Some subtypes of HIV-1 can produce falsely low

>results

> > > on certain viral load tests. (For example, the PCR viral load test

>used

> > > in many US labs can show falsely low levels of the subtype E virus

> > > commonly found in Thailand.) If this person has a viral subtype more

> > > common in Africa or Asia and has been getting PCR (Amplicor) viral

>load

> > > testing, then a bDNA (Quantiplex) viral load test might give a more

> > > accurate result. But even with subtype B infection, which is most

>common

> > > in the US and western Europe, the effect of a given viral load on

>the

> > > T-cell count will vary from one person to another.

> > >

> > > The actual number of the viral load is less important than the

>effect

> > > the virus is having on the immune system, as shown by the CD4 count.

> > > Accordingly, treatment guidelines recommend starting antiretroviral

> > > treatment for HIV-infected individuals with low CD4 counts

>regardless of

> > > viral load. Based on the information presented, this person is at

> > > serious risk of developing an opportunistic infection. He should

>seek

> > > medical care which will likely include prophylaxis against PCP and

>MAC

> > > infection, in addition to antiretroviral therapy.

> > >

> >

>

>

_________________________________________________________________

Play Q6 for your chance to WIN great prizes.

http://q6trivia.imagine-live.com/enca/landing

[Guest guest]

Don't get too hung up on your counts. Have been alive for 24 years now with

a CD4 count that has fluctuated between 11 and 460. Take care of yourself,

don't party too much and decide to stay alive. You'll be fine.

>

>To: PozHealth

>Subject: Re: Can you explain low CD4 counts at a low viral

>load? more info

>Date: Sat, 12 Aug 2006 09:28:43 -0000

>

>

>Truly fascinating. The discordant piece in your situation is that your

>T4 numbers are so very low 257-263 and 17.1% - 18%. This is not typical

>of people with a strong immune response to HIV. If you are truly in the

>category of people whose immune system can control HIV your T4 numbers

>should rise back to normal over time.

>

>Since it is a strong possibility that you have Subtype E HIV, most

>common in Thailand, there is still a question how reliable viral load

>tests are - since the tests were not designed for Subtype E and there is

>a known question about reliability with this Subtype. If your virus

>hasn't been typed in the lab to determine if it is Subtype E, I think it

>might help answer what is really going on.

>

>The progression of Subtype E HIV is also somewhat different. This is a

>presentation regarding the progression of patients in Thailand with

>Subtype E virus from the 2001 Conference on Retroviruses and

>Opportunistic Infections.

>

>http://www.retroconference.org/2001/posters/207.pdf

><http://www.retroconference.org/2001/posters/207.pdf>

>

>You'll notice (on Slide 14) that for some reason, in these people

>studied, survival with Subtype E HIV takes a big decline around 8 years

>after infection. For some reason, survival with Subtype E is not as

>favorable as Subtype B, although those with Subtype E virus and low

>viral load have a dramatically better survival history. The treatments

>which are most effective for Subtype E are also somewhat different. So

>typing your virus would be important if you haven't already done so.

>

>I have a friend in Sweden who has a very high level of T Regulatory

>Cells (T4) and CNAR T8 cells. He has been HIV+ for six years. Initially,

>his viral load was around 25,000 and his T4 numbers were 550 and 26%.

>

>But without drugs and not needing Interleukin-2, since his TReg and CNAR

>was already high, his viral load is now 1,100 and his T4 numbers are 980

>and 35%. Studies of prostitutes in Africa who are HIV negative, yet

>probably exposed to HIV on a daily basis, have even higher levels of T

>Regualtory Cells and CNAR T8 cells - these are your immune system's key

>to controlling HIV. So if you have the option of doing so, you could

>also measure your percentage of T Rregulatory cells - CD4+/CD25+ is a

>good approximation.

>

>

>

> > >

> > >

> > > Healthyseed found this " Question and Answer " from UCSF, which

>appears to

> > > explain his paradox of an abnormally low viral load test results

>with

> > > sub-type E HIV.

> > >

> > > Can you explain low CD4 counts at a low viral load?

> > >

> > > May 16, 2000 -- Answered by ce Peiperl, MD, HIV InSite Medical

> > > Editor

> > > http://hivinsite.ucsf.edu/insite?page=ask-02-02

> > > <http://hivinsite.ucsf.edu/insite?page=ask-02-02>

> > >

> > >

> > > Question: My friend was diagnosed with HIV in 1995. At that time,

>his

> > > CD4+ count was about 900/mm of blood and viral load approx. at 9,000

> > > copies/ml. He stayed at this CD4+ level for a couple of years, while

>his

> > > viral load went down to about 3,000/ml. In 1998, his T-cell count

>took a

> > > downward plunge at was at 69CD4+/mm. His viral load grew to 6,000

> > > copies. Last month, the results of Tcell and viral load tests were

>CD4+

> > > at 34/mm and viral load at 11,000/ml. His doctor isn't certain why

>this

> > > (viral load), historically has been low.

> > >

> > > He has never taken antiretrovial medications, to date has not had an

> > > opportunistic infection, but several years before, was tested + for

>HBV.

> > > Is there an explanation for this situation? I am an HIV community

> > > educator and do a great deal of research to keep myself up to date

>(as

> > > much as possible). I have been unable to find info on my friend's

> > > situation. What is his prognosis? Can you help?

> > >

> > >

> > > Answer: It is not that unusual to have low CD4 counts at a

>relatively

> > > low viral load. Some subtypes of HIV-1 can produce falsely low

>results

> > > on certain viral load tests. (For example, the PCR viral load test

>used

> > > in many US labs can show falsely low levels of the subtype E virus

> > > commonly found in Thailand.) If this person has a viral subtype more

> > > common in Africa or Asia and has been getting PCR (Amplicor) viral

>load

> > > testing, then a bDNA (Quantiplex) viral load test might give a more

> > > accurate result. But even with subtype B infection, which is most

>common

> > > in the US and western Europe, the effect of a given viral load on

>the

> > > T-cell count will vary from one person to another.

> > >

> > > The actual number of the viral load is less important than the

>effect

> > > the virus is having on the immune system, as shown by the CD4 count.

> > > Accordingly, treatment guidelines recommend starting antiretroviral

> > > treatment for HIV-infected individuals with low CD4 counts

>regardless of

> > > viral load. Based on the information presented, this person is at

> > > serious risk of developing an opportunistic infection. He should

>seek

> > > medical care which will likely include prophylaxis against PCP and

>MAC

> > > infection, in addition to antiretroviral therapy.

> > >

> >

>

>

_________________________________________________________________

Play Q6 for your chance to WIN great prizes.

http://q6trivia.imagine-live.com/enca/landing

[Guest guest]

Don't get too hung up on your counts. Have been alive for 24 years now with

a CD4 count that has fluctuated between 11 and 460. Take care of yourself,

don't party too much and decide to stay alive. You'll be fine.

>

>To: PozHealth

>Subject: Re: Can you explain low CD4 counts at a low viral

>load? more info

>Date: Sat, 12 Aug 2006 09:28:43 -0000

>

>

>Truly fascinating. The discordant piece in your situation is that your

>T4 numbers are so very low 257-263 and 17.1% - 18%. This is not typical

>of people with a strong immune response to HIV. If you are truly in the

>category of people whose immune system can control HIV your T4 numbers

>should rise back to normal over time.

>

>Since it is a strong possibility that you have Subtype E HIV, most

>common in Thailand, there is still a question how reliable viral load

>tests are - since the tests were not designed for Subtype E and there is

>a known question about reliability with this Subtype. If your virus

>hasn't been typed in the lab to determine if it is Subtype E, I think it

>might help answer what is really going on.

>

>The progression of Subtype E HIV is also somewhat different. This is a

>presentation regarding the progression of patients in Thailand with

>Subtype E virus from the 2001 Conference on Retroviruses and

>Opportunistic Infections.

>

>http://www.retroconference.org/2001/posters/207.pdf

><http://www.retroconference.org/2001/posters/207.pdf>

>

>You'll notice (on Slide 14) that for some reason, in these people

>studied, survival with Subtype E HIV takes a big decline around 8 years

>after infection. For some reason, survival with Subtype E is not as

>favorable as Subtype B, although those with Subtype E virus and low

>viral load have a dramatically better survival history. The treatments

>which are most effective for Subtype E are also somewhat different. So

>typing your virus would be important if you haven't already done so.

>

>I have a friend in Sweden who has a very high level of T Regulatory

>Cells (T4) and CNAR T8 cells. He has been HIV+ for six years. Initially,

>his viral load was around 25,000 and his T4 numbers were 550 and 26%.

>

>But without drugs and not needing Interleukin-2, since his TReg and CNAR

>was already high, his viral load is now 1,100 and his T4 numbers are 980

>and 35%. Studies of prostitutes in Africa who are HIV negative, yet

>probably exposed to HIV on a daily basis, have even higher levels of T

>Regualtory Cells and CNAR T8 cells - these are your immune system's key

>to controlling HIV. So if you have the option of doing so, you could

>also measure your percentage of T Rregulatory cells - CD4+/CD25+ is a

>good approximation.

>

>

>

> > >

> > >

> > > Healthyseed found this " Question and Answer " from UCSF, which

>appears to

> > > explain his paradox of an abnormally low viral load test results

>with

> > > sub-type E HIV.

> > >

> > > Can you explain low CD4 counts at a low viral load?

> > >

> > > May 16, 2000 -- Answered by ce Peiperl, MD, HIV InSite Medical

> > > Editor

> > > http://hivinsite.ucsf.edu/insite?page=ask-02-02

> > > <http://hivinsite.ucsf.edu/insite?page=ask-02-02>

> > >

> > >

> > > Question: My friend was diagnosed with HIV in 1995. At that time,

>his

> > > CD4+ count was about 900/mm of blood and viral load approx. at 9,000

> > > copies/ml. He stayed at this CD4+ level for a couple of years, while

>his

> > > viral load went down to about 3,000/ml. In 1998, his T-cell count

>took a

> > > downward plunge at was at 69CD4+/mm. His viral load grew to 6,000

> > > copies. Last month, the results of Tcell and viral load tests were

>CD4+

> > > at 34/mm and viral load at 11,000/ml. His doctor isn't certain why

>this

> > > (viral load), historically has been low.

> > >

> > > He has never taken antiretrovial medications, to date has not had an

> > > opportunistic infection, but several years before, was tested + for

>HBV.

> > > Is there an explanation for this situation? I am an HIV community

> > > educator and do a great deal of research to keep myself up to date

>(as

> > > much as possible). I have been unable to find info on my friend's

> > > situation. What is his prognosis? Can you help?

> > >

> > >

> > > Answer: It is not that unusual to have low CD4 counts at a

>relatively

> > > low viral load. Some subtypes of HIV-1 can produce falsely low

>results

> > > on certain viral load tests. (For example, the PCR viral load test

>used

> > > in many US labs can show falsely low levels of the subtype E virus

> > > commonly found in Thailand.) If this person has a viral subtype more

> > > common in Africa or Asia and has been getting PCR (Amplicor) viral

>load

> > > testing, then a bDNA (Quantiplex) viral load test might give a more

> > > accurate result. But even with subtype B infection, which is most

>common

> > > in the US and western Europe, the effect of a given viral load on

>the

> > > T-cell count will vary from one person to another.

> > >

> > > The actual number of the viral load is less important than the

>effect

> > > the virus is having on the immune system, as shown by the CD4 count.

> > > Accordingly, treatment guidelines recommend starting antiretroviral

> > > treatment for HIV-infected individuals with low CD4 counts

>regardless of

> > > viral load. Based on the information presented, this person is at

> > > serious risk of developing an opportunistic infection. He should

>seek

> > > medical care which will likely include prophylaxis against PCP and

>MAC

> > > infection, in addition to antiretroviral therapy.

> > >

> >

>

>

_________________________________________________________________

Play Q6 for your chance to WIN great prizes.

http://q6trivia.imagine-live.com/enca/landing

[Guest guest]

yes, all of the below, and particularly " decide to stay alive. "

The Australian aborigines had a bone-pointing ritual in their culture,

as a punishment. Those at whom the bone was pointed went off to die.

We need to help get the bone-pointing out of the HIV story.

Wish you another 24.

>

> Don't get too hung up on your counts. Have been alive for 24 years

now with

> a CD4 count that has fluctuated between 11 and 460. Take care of

yourself,

> don't party too much and decide to stay alive. You'll be fine.

>