Hello all...with a question...or two.

[richabk]

Hi all,
My best friend and someone whom I love more than anyone else is positive. Growing up in a small town in Alabama, I didn't have any exposure to HIV/AIDS. But after I moved to NYC and met my friend, I try to learn as much as I can - especially since we've grown so close and depend on each other. He's been positive for almost 15 years.
A little over a year ago he went on his 1st med vacation which turned out to be a disaster. His doctor switched his meds when he came back (less side effects they said) but the doctor didn't switch the dosage after the trial period (to make sure there wouldn't be any negative side effects) and my friend became resistant to all NNRTIs. He has since switched doctors and has gone back to his original medicines with as much normalcy as one can.

Here are my questions:
1. Since switching meds, his viral load has been undetectable (< 400)....but his T-cells haven't really gone up as much as I thought they would (they've hovered around 300). Are viral load and T-cells related? If the viral load is undetectable shouldn't the T-cells go up?

2. I saw that some of you are in sero-discordant relationships. Even though we're not partners, we're still the closest people in each others' lives. I would greatly appreciate learning anything from people in this type of relationship.

Thanks,
B

[JackBeck]

1. I'll try your first question.

A viral load test is taken to see whether or not a certain drug regimen is working. It's not really looked at as an indicator of what is going on with a person's immune system. Having an undetectable viral load is great news for your friend!

The CD4/T-cell count is a much better indicator of immune system health. Since you say that your friends T-cells have hovered around 300 is also good news. As long as their T-cells don't continue to trend downward, there is no need to be concerned. A better indicator of immune health is the CD4%, which people tend to think about. CD4% results also come back in the same test results. The CD4% tends to be a more steady number, when compared to the CD4 count, which can fluctuate depending on the time of day, etc.

As for your second question, I cannot help you there. Both my husband and I are negative. But I work as a HIV/HCV Health Educator, so if you have any other questions, I'll do my best to answer them. I'm not a doctor, so this isn't medical advice. I'm a good ol' not-for-profit boy.

[pinto]

2. I'll echo JackBeck. Good to hear his viral load is so low.

Viral load is just what it sounds like - the "load" or detectable amount of free virus in the bloodstream.

From my experience, CD4 counts don't respond as quickly to a med regimen as does viral load and many docs look to CD4/CD8 ratios as a better gage of immune function. Disclaimer - I'm not a doc either, this is info gleaned as the customer, so to speak. These are good points for him to review with his doc.

I don't have any first hand experience to share on discordant couples, but I know a few - and they seem as tight as any other couples I know.

Sounds like he's got a good friend in you.

:hi:

[nealmhughes]

3. My physicians at UAB medical school, one of the best ID schools in the US,

told me that my VL would drop exponentially towards a assymptote of "non-detectable" and that my CD4 would increase arithmetically, which has proven true for me.

My CD4 is 300 ish right now and I am fine, physically, but I do avoid crowds, to play it safe.