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7 yrs positive...

Dec 9, 2007

You recently responded to my questions about vl and cd4 count...see previous my previous question titled: 7 yrs Positive. You stated that I did not indicate how long I have been that title!! lol An oversight? lol

You show some concern re: my viral load going from 27,000 to 2000 something or whatever...isn't this a good thing? But my query re: how it could have been that high and not ever resembeling that again and clinic telling me it must have been a different type of test (as it was not done at this clinic) was not addressed. Are there different tests that different docs/facilities would use? How could it be? You also indicated that you would expect treatment to begin before the less then 200 CD4 mark...lest I remind you that I am dealing with the government here and that they have their own guidelines for when treatment should begin? Again I am at the mercy of Medicare and Medicaid...they determine when I will start treatment...not even my docs can determine that for me and for sure. Do you realize that some in North Carolina, for example on Medicare and other low income inability to pay for the meds were put on a 'waiting list' for the expensive meds and that some died before meds were approved for payment? Sucks. Truly sucks! I have a multitude of other 'stuff'...Multiple Sclerosis, Degenerative Disc Disease, Fibromyalgia, heart condition, COPD...etc. etc. the docs seem to lump things into other catagories so my exhaustion and severe bloody noses are pretty much ignored. Tossed from one 'specialist' to one is centered...all inclusive. Having a mulititude of things to deal with docs pass me back and forth and I am not being helped to the best ability I believe. I know this is not an 'all' forum but I believe that at least some of my negative and somewhat dilbiltating symptoms are HIV related yet they are passed off as 'other'. I am at a loss as to who to turn to. I am crazed, as I usually am awaiting the results of my most recent labs...another two weeks and I'll know if this time I'll be put on the list of waiting to see if meds will come before I get too sick to bring back. Sad...and suffering. Thanks for listening and any furthur help that you can extend!

Scarey stuff when you are at the mercy of others!

Just feeling out of any control over what is and isn't going to happen. I can not be proactive if I am constrained to do the best for me.

Response from Dr. Holodniy

Yes, I did miss the infection duration in the title.

Yes, there are different viral load assays and they can have somewhat different results. A decline is always a good thing, if its real. That is a 1 log or 10-fold change and would be considered significantly different (over and above assay variability for the same assay, and even a significant difference if it were a different assay).

I am aware of the North Carolina and other States issues about waiting lists for HIV medications. My answer reflects what thresholds for treatment HIV practitioners would agree treatment is indicated. I am sorry the programs there or in other places may not see it that way, either because of lack of funds or other reasons.

CD4 changes
Drop in viral load

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