2nd labs re: cd4 and shingles

Question

Hi I asked a question a couple of weeks back. Here's a summary with my new numbers.

I tested positive 3 months ago in the middle of a bout of shingles. I had a negative rapid and 2 week blood test one year and 4 months ago.

My first results were as follows (cd4=384) (vl=25000) (cd4% 20)

I had repeat blood tests around 3 weeks after the shingles disappeared. I got the results today. cd4 382.

  1. While I understand the cd4 average is 500-1200 for HIV- people, is it not usually older people who have a cd4 on the lower end of the scale? I have been infected for one year, is mycd4 drop not quite steep? Does this indicate a aggresive strain of HIV? And can an aggresive form of Hiv contribute to an accelrate decline n cd4 even wihout a high viral load?

  2. The Doctor did not repeat my viral load becausese deemed it unnecessary. However, is it not possible that my aciclovir treatment could have given me an artificially low viral load of 25k? And isn't it important to monitor the viral load everytime bloods are taken giventhat I'm not that far off cd4 350 and i was on aciclovir when i had my blood takn? They say my next tests will be taken 2 months fom now. Is this an acceptable time frame in your opinion?

I also received resistance results. I have low level resistance to Ziovudine and Stevudine which they said means i have potential resisance to all NRTIs.

  1. What does this mean for my treatment options? How likely is it that i will be cross resistant to all nrtis like tenofovir? If I am, can I survive long enough on meds i am currently not resistant to until new ones comes out?

  2. Am I right in thinking that even with adhrence, after 10 or more years, resistance tends to develop?

I am 22 male living in the UK

So sorry for the longmessage I am very concerned about the resistance and don't have 100% confidence in the nurses i have seen. To quote one i saw today 'i haven't got a clue about cd4%'! A reply would be so well received.

I wish you and your family and friends a very Merry Christmas. Thanks so much for your support. This site has been invaluable to me in the last few weeks .

Answer

  1. Older does not necessarily mean less CD4 cells, although the quality (function) may diminish. Your CD4 count went from 384 to 382. That is no change. Yes, an aggresive form of HIV could deplete CD4 cells faster.
  2. Unlikely acyclovir would have decreased your HIV viral load. Two months is just fine for retesting.
  3. It would be important to know the specific results (i.e. whether this was a phenotype or genotype test, and if so, which mutations were present). Whether tenofovir works is dependent on which mutations are present. In addition, you have plenty of other options for treatment without those two drugs.
  4. Depends on the patient, virus, adherence patterns, other medical conditions, drug interactions, among other reasons. Many people are having long term successful outcomes, where resistance has not developed.