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cd4 dropped from 1000 to 500 in 3 months


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hey guys, Im on meds since 2016....always undetectable....CD4 always higher than 800.

Today I took a cd4 test and its 500....never been this low...

im really worried.... Im always in saunas, sex clubs...

is it possible that I got re-infected and the meds stopped working???? I take the meds every night since 2016....

I took the Viral Load test and its gonna be ready only in 7 days...So Im freaking now right now..

tks

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4 minutes ago, tomzefis said:

 

hey guys, Im on meds since 2016....always undetectable....CD4 always higher than 800.

Today I took a cd4 test and its 500....never been this low...

im really worried.... Im always in saunas, sex clubs...

is it possible that I got re-infected and the meds stopped working???? I take the meds every night since 2016....

I took the Viral Load test and its gonna be ready only in 7 days...So Im freaking now right now..

tks

You could have an ordinary, everyday infection that lowered your CD4.....Re-infection is very rare 

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1 hour ago, tomzefis said:

 

hey guys, Im on meds since 2016....always undetectable....CD4 always higher than 800.

Today I took a cd4 test and its 500....never been this low...

im really worried.... Im always in saunas, sex clubs...

is it possible that I got re-infected and the meds stopped working???? I take the meds every night since 2016....

I took the Viral Load test and its gonna be ready only in 7 days...So Im freaking now right now..

tks

Also, the CD count varies during the day, sometimes quite significantly. As @Marlin said, you are most likely having an infection going on. It could be just a flu.  The CD count needs to be interpreted in context. If you are clinically healthy, than it's worth doing some other tests to determine if the source of the cd count drop is not somewhere else. 

Also, as you are saying that you are always in saunas and sex clubs, check for other STDs. You may be asymptomatic on a number of infections. Also, check for fungal infections. These are notoriously difficult and can trigger the drop.

Otherwise, if you feel OK don't worry. But take a break from fucking for a few days. And equally important, don't use poppers for a while. Their oxidative nature makes them a reasonably important co-factor in lowering your immune barriers. 

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CD4 counts can vary for many reasons.  Regular infections (flu, etc) will also impact other parts of your immune system, in particular the CD8 counts.  However, CD4 and CD8 will lower or increase together.  So, your bloodwork may also have a percentage report on the CD4/CD8 ratio.  40% ratio is ideal but anywhere from 30-60% is "fine". 

My CD4 counts can vary by several hundred points but the ratio with CD8 is always around 40%. That means I'm fine. 

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The "reading" itself could have been off.  I had my labs drawn the last week of December, and came back with a viral load of 111.  My doctor's office called me and reordered the test, asking if I had been taking the medication as I had been undetectable (or less than 50) for quite some time.  They wanted to make sure I was taking the medication as they have zero tolerance for non-compliance.  They reordered just the viral load test from Quest and we agreed I will see them the beginning of February.

Also, I recently began a medication that has proven to decrease the proficiency of my Prezcobix.  Before I even started taking the additional medication my pharmacist called me and told me they had information that the two meds didn't mix well, but for me, both are medically necessary.  Have you added any new medications recently?

Don't panic, it could just be a false reading.  A good doctor knows these numbers can fluctuate.  What has been stressed to me is that the viral load is the important issue, T cells not as much.  Good luck!

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24 minutes ago, ellentonboy said:

 What has been stressed to me is that the viral load is the important issue, T cells not as much.

This is what I get from my specialist as well. Even though my CD4 count lives stubbornly in the 300s now, she’s comfortable with it in spite of the fact that a normal range is 500-1500. The key is staying above 200, and if the viral load is controlled, there’s little reason to be concerned about dropping to that level.

Although a 500-point drop in CD4 is certainly something to be investigated in someone with HIV, remember - 500 is still a level you could expect even if you didn’t have HIV. It’s within the normal range, and as others have stated, there are several reasons why a person’s system could register such an effect under duress. A superinfection with a resistant HIV strain while you’re in treatment would seem among the less probable explanations.

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1 hour ago, hairyone said:

 

CD4 counts can vary for many reasons.  Regular infections (flu, etc) will also impact other parts of your immune system, in particular the CD8 counts.  However, CD4 and CD8 will lower or increase together.  So, your bloodwork may also have a percentage report on the CD4/CD8 ratio.  40% ratio is ideal but anywhere from 30-60% is "fine". 

My CD4 counts can vary by several hundred points but the ratio with CD8 is always around 40%. That means I'm fine. 

cd4/cd8 for me is 0,45 today

2 hours ago, VersGuyAnon said:

What did your consultant/medical professional say? 

I did not go there yet. I just did a random blood test

1 hour ago, ellentonboy said:

The "reading" itself could have been off.  I had my labs drawn the last week of December, and came back with a viral load of 111.  My doctor's office called me and reordered the test, asking if I had been taking the medication as I had been undetectable (or less than 50) for quite some time.  They wanted to make sure I was taking the medication as they have zero tolerance for non-compliance.  They reordered just the viral load test from Quest and we agreed I will see them the beginning of February.

Also, I recently began a medication that has proven to decrease the proficiency of my Prezcobix.  Before I even started taking the additional medication my pharmacist called me and told me they had information that the two meds didn't mix well, but for me, both are medically necessary.  Have you added any new medications recently?

Don't panic, it could just be a false reading.  A good doctor knows these numbers can fluctuate.  What has been stressed to me is that the viral load is the important issue, T cells not as much.  Good luck!

they changed my medication in March ( to a medication that is less likely to injury my kidneys )....in May cd4 was 1000....and viral load undetectable

guys, thank you for all the answers. Im trying to answer more of u guys but im getting blocked here

 

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2 hours ago, tomzefis said:

they changed my medication in March ( to a medication that is less likely to injury my kidneys )....in May cd4 was 1000....and viral load undetectable

Same thing happened here. In the spring I was shifted to a new med for the exact same reason, and by August I had the highest viral load I’d seen since I started meds - still untransmittable, but that was the absolutely wrong direction to be going. My CD4 didn’t take too bad a hit, then, but it just goes to show that one size does not fit all when it comes to HIV meds.

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4 hours ago, tomzefis said:

cd4/cd8 for me is 0,45 today

 

You're doing fine.  It sounds like your whole body is under general stress from flu, or minor infection, or just plain worn out (too many holiday parties?).  Get some rest and take some extra care of yourself for a couple of weeks. 

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14 hours ago, Jandrosgape said:

Reagents or other testing materials could be suspect.   ESPECIALLY if Quest is the precessing lab.  

Well that is a sobering post.  Quest is the only lab I can use based on my insurance, so I guess I might inquire with my doctor since he reordered my viral load test.  I'm being accused of not taking my medication because of a viral load of 111, the nurse made me feel like a criminal on the phone when she said the doctor asked I retake the test before my next appointment.  YIKES!

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54 minutes ago, ellentonboy said:

Well that is a sobering post.  Quest is the only lab I can use based on my insurance, so I guess I might inquire with my doctor since he reordered my viral load test.  I'm being accused of not taking my medication because of a viral load of 111, the nurse made me feel like a criminal on the phone when she said the doctor asked I retake the test before my next appointment.  YIKES!

Quest is fine, don't let a comment upset you.....and your nurse sounds like a horrible caregiver. Mention it to your doc. No one should be admonished. As for your 111 reading that's simply a blip. It happened to me one time. I was 100% adherent. Doctor wasn't concerned but did ask me if I was taking any other OTC medications. She said even antacids like TUMS taken a few hours around the time you take your meds can effect absorption. I wasn't taking anything else and the my next 6 month check I was undetectable.  

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I've had VL blips over the last 13 years. Have never been off my meds since I started. I had 3 blips while on Atripla. 3rd blip was an indication of being resistant to one of the components of Atripla. Switched to Genvoya, had a blip there, then finally on Biktarvy. No blips in VL 4.5 years on Biktarvy. As long as my doctor says my CD4 are good, usually between 275-325, and I have an undetectable VL, I'm good to go. No news is good news.

The nurse at the ID doctor I go to was the same way to my wife, then girlfriend. Treated her like shit. Very disrespectful. Told my doctor. I don't think she stayed too much longer after that.

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Important to remember: just because you rise from <25-level undetectable to 111-level (which is still untransmissible territory, and which used to be within the realm of "undetectable" before more accurate tests were devised) does not mean your viral level will stay there. It can go up or down (as noted, in part because of interactions with other meds, etc.) so the more important thing is to keep monitoring the trend line. If viral load continues to rise, test after test, then there's cause for concern. But a one-time level "up" like that is not.

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