Forum on Understanding Your Labs

please help

Wed, 17 Jan 2018 21:45:53 -0400

Q: i have recently been diagnosed with the hiv virus im confused and dont know what to do, my doctor told me mt cd4 is around 800+ which is ok, i wanna live a healthy life style and make sure it doesnt decrease im willing to do anything aslong as i live a healthy life style, the clinic that i attend they dont seem to have that human nature with the patience and that is very upsetting they didnt even tell me for how long ive had it for, and im trying to mantain this positive attitude of getting help...

A: Hello and sorry to learn about your recent diagnosis.First off, don't feel put off that your providers can't tell you how long you've been living with the virus. There simply isn't s lab test that gives us this answer, and the rate of CD4 cell decline among untreated people living with HIV is highly variable. It's virtually impossible to give you this answer without a series of negative HIV tests followed by a positive result. You're on the right path to living healthy- getting tested and linke...

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about rickettsia fights HIV/aids

Sun, 14 Jan 2018 18:22:53 -0400

Q: How rickettsia fights against HIV/AIDS

A: Rickettsia bacteria must be inside human cells in order to cause infection and survive. It has been observed that certain Rickettsial species causing infection also cause an immune response that can control HIV replication inside cells. Whether such a phenomenon can be exploited to control HIV infection requires more research.

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Genvoya Blip

Sun, 14 Jan 2018 18:17:50 -0400

Q: I am scared. I am 70 years and have had HIV for 4 years on a Genvoya Regime. I have had slight blips in viral load Cd4 is 680- continuing to climb.Today I got my blood Work and my viral load went up to 196 from undetectable and I have never missed a dose. Doc said not to worry and will check in 3 months. But I am worried! All other labs are good. Does this mean Genvoya is not working. Could drinking 2 glassses of wine a night interfere with the meds. I am kind of flipping out.Should I Be worried

A: To be clear, you have been taking Genvoya for 4 years and your HIV viral loads have been generally undetectable for that time, with an occasional blip over the 4 years of time, and your CD4 count/percent have been stable or increasing? If true, then I am not concerned and agree with your doctor. I don't think the wine is a factor here.

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CD4 and CD8 fluctuations: Please answer, really worried

Sun, 14 Jan 2018 18:11:52 -0400

Q: Hi Doctor,I just finished and regine of PEP (Truvada and Isentress) for 28 days. In order to monitor myself during this proess, i had some cd4/cd8 ratio profiles done. My last test was 4 days post PEP which is too early to test for HIV. My test should a CD4 abosute of 1118 which is a rise of 312 from the previous test (CD4% is 41) and a CD8 absolute of 702 which is a rise of 212. (CD8% 26%). the ratio is 1.59 and has been consistently falling over the time on PyP. My questions are as follows: 1....

A: I am not sure why you would want to measure CD4/CD8 counts during PEP. Those are all normal levels.

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2 months on treatment

Sun, 14 Jan 2018 18:09:50 -0400

Q: hello doctor. I was diagnosed in acute state on 20 th of october 2017. The contamination date is 24 september (100% sure). My cd4 count at diagnosis was 209 and viral load 10 mil +. I started treatment with emtriva+viread+prezista(800)+norvir(100)+issentress.After 2 months the cd4 count is 419. No other analyses were made(doctors say we need to wait for the body to adjust because it is a very powerful treatment and there is no need for viral load checks) Is it probable to have the cd4 boost from...

A: Although we usually don't know what the Cd4 count/percent is prior to HIV infection, to answer your question, yes, your CD4 count increase is the result of a combination effect from both the HIV meds and the immune system. Yes, HIV can circulate through the blood that goes to the brain, but HIV meds will significantly reduce this virus load, so any residual amount of virus left in the brain (or other body organs for that matter) will be reduced to almost undetectable levels.

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Am I failing?

Sun, 14 Jan 2018 18:04:28 -0400

Q: Hi Dr. Holodniy:I've been + for 22 yrs. Since 1996 I've NEVER been detectable ... until now. Before 2010, my health group tested to <72. Since then <48.I switched from Tivicay/Truvada to Tiv/Descovy in Aug 2016. Before switching, VL Always: < 48. But then Four mos. later (Dec): 105. Jan 2017: 74. Mar: 102. May: 103. Aug: 50. Dec: 303. My Dr. says don't worry. These are only blips. If you were failing your #'s would steadily jump up. He said a genotype resistance test would be a waste of time. H...

A: I agree with your conclusions and see this as a trend of consistently being positive and not blipping. Although it appears the timing of these detectable viral loads occurred after switching HIV meds; the only difference between those two regimens is the form of tenofovir in Descovy, which should have not had any effect on regimen potency and therefore your viral loads should have remained undetectable. Although it is true that a standard HIV resistance test in blood plasma can't be performed be...

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Viral load

Sun, 14 Jan 2018 17:52:39 -0400

Q: I was Undetectable last yr. But it says viral RNA detected 38 copies/ml. What does it mean? I am not Undetectable anymore?

A: You don't indicate if your are taking HIV meds (and have been compliant), which particular HIV meds, your CD4 count and HIV viral load prior to starting HIV meds and your CD4 count now, and whether there are any other ongoing medical conditions or infections. Assuming you are taking HIV meds as prescribed, I am not concerned. People can see intermittent blips of HIV viral load above the assays lower limit of detection. We only start to get concerned with the HIV viral load remains consistently a...

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Prolonged treatment interruption

Sun, 14 Jan 2018 17:45:31 -0400

Q: Hi Dr, I know this is a controversial question to answer but I need help. I have been off meds for 10 days and more likely to be so until 31 January '18. In my three years since diagnosis I have been fully adherent to my treatment. My last lab results were UD with a TC count of 650+. I am unable to afford meds due to having no money and recently been unemployment. I prefer to buy my own meds instead of going the public health care clinics. The stigma is still a problem in my country and I don't ...

A: Resistance to Trivenz will not be a problem when you go back on your HIV meds. Once you are off the meds, the HIV viral load will begin to increase after a week or so. Because you are not taking meds, there is no pressure on the virus, so resistant virus is usually not a problem. Depending on how long you are off meds, you may or may not see a drop in CD4 count or percent.

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HEPATITIS B VIRAL LOAD

Sun, 14 Jan 2018 17:39:41 -0400

Q: I was tested for hepatitis b viral load and it is 620ml.Is it still low or it requires treatment,please advise me.

A: You don't indicate why this test was performed or whether other HBV tests were performed. That would be considered a low HBV viral load. Other testing may be indicated to determine whether HBV treatment is indicated at this time. I suggest you consult with a liver specialist.

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HBV PCR TEST RESULT

Sun, 14 Jan 2018 17:39:18 -0400

Q: I want to know that HBV PCR LIAD TEST RESULT 7959. IS IT SEVER OR NOT

A: You don't indicate why this test was performed or whether other HBV tests were performed. That would be considered a low HBV viral load. Other testing may be indicated to determine whether HBV treatment is indicated at this time. I suggest you consult with a liver specialist.

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HBV DNA

Sun, 14 Jan 2018 17:37:35 -0400

Q: Hi,My auntie's HBV DNA last year was 203 iu/ml with normal alt test and this year jump to 1,655 iu/ml with normal alt test. She's not taking any medicine except for high blood pressure. Is she on "inactive stage"? What will be the prognosis for her at age 68

A: I don't know what you mean by inactive. She has chronic HBV infection with a low viral load. Other tests may be indicated to determine whether HBV treatment is indicated at this time. I suggest she consult with a liver specialist.

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Memory issues

Tue, 09 Jan 2018 01:03:21 -0400

Q: I wanted to know if there has been any medication that helps those with HIV deal with memory decline? I hear even the latest medication doesn't help memory decline for those with this virus for 20 plus years. Is the only treatment currently vegetables and exercise?

A: Thanks for your question. Those of us living with HIV can experience HIV-Associated Neurocognitive Disorder. Symptoms include subtle memory issues, fine motor concerns (for example, hand writing deteriorates), and balance issues. Many of these are indistinguishable from other memory issues common to aging.As is the case for memory concerns in general, there is no specific medication that will improve HIV-related cognitive concerns. There are, however, things we can do. You mention exercise and a...

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Please help

Sun, 07 Jan 2018 18:28:38 -0400

Q: Dear DoctorsI have been testing negative for HIV from 2011 to December 2015. I didn't test in 2016. I tested positive in March 2017 with a CD4 of 189. Can a CD4 drop this quick or have I been getting false negative results all these years? I'm really struggling to cope with everything because of this, please help in clarifying this. I'm on medication for the past seven months and VL is 100. I'm now contemplating suicide.

A: Since we don't usually get CD4 counts in people without HIV infection, it is always hard to know where people start, since the normal range is from about 500-1500. In addition, during acute HIV infection, the CD4 count can drop significantly before the immune system mounts a response and the CD4 count recovers over weeks to months after infection. I don't think in your case this is an issue that the tests missed the infection in past years. It is more likely an acute decline after recent infecti...

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Help with medical issues

Sun, 07 Jan 2018 18:21:25 -0400

Q: Having had a Needlestick injury at work as RN In 1996 and was not given the information that I was positive but bloods luckily were in storage. have been started on triumeq after being on Nevirapine/truvada since 2007I am positive for HLA B5701 and a lot of General Practitioners dont understand half of what Im trying to discuss with them. Before Christmas my R Testes blew up with fluid about 8 times the size Ayer going to GP he wanted to give me Ciprofloxacin 500mgs BD for 14 days without so mu...

A: Regarding the acute issue in the right testicle, hard to know exactly what that might be without some more definitive work-up (ultrasound, needle aspirate, etc). Although it is likely to be an infection, given the rapid onset, what kind of infection, requires additional testing. Cipro may or may not be effective. If the swelling resolves, then it may have been the correct choice. If not, you probably need to go to a urologist and get it worked up.

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Missed doses

Sun, 07 Jan 2018 18:16:08 -0400

Q: Hello,I have been undetectable for 5 years now. Question is that I ran out of medication and it's been day 5 with out taking genvoya. I called my case manager and he said because of the holidays delays he will let me know when I can get my medication because of ADAP AKA gov assistance. What are my chances to go from undectable to detectable?

A: We can begin to see low detectable HIV viral loads a week after stopping HIV meds. In some people it can take longer, depending on good their immune system is in controlling the virus on its own. The higher the CD4 count, the better. In general though, if you restart your HIV meds after 5 days of being off meds, and you retest your HIV viral load after a month or so, it will still be undetectable.

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Frequency of blips

Sun, 07 Jan 2018 18:10:59 -0400

Q: Hello. I am from Turkey. I was diagnosed with 130.000 rna in february 2015. Started on stribild. March -Negative. From then, every 3 months a check, and always took my stribild. Negative (n), n, n, n, n, first blip on June 2016 with 130 copies, n, n, second blip in March 2017 with 72 copies, June 2017 negative, september 2017 blood sample was lost (sloppy lab work) so no data, now December 2017 with 60 copies. I switched to Genvoya in December.Cd4 rose from 490 to 990+ and a very strong %36 and ...

A: I am not concerned. Unfortunately we can see this kind of blipping pattern, but in most people, the HIV viral load becomes undetectable, and we don't see any loss of CD4 count or percent. Switching HIV regimens, as you did, can help in some situations, but not all. We become more concerned when the viral load remains above 200 copies/mL or higher. That usually indicates that HIV treatment failure is a possibility. But I don't think that is an issue in your case.

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HIV POSITIVE early questions

Sun, 07 Jan 2018 18:06:09 -0400

Q: Can hiv be cured in an 18 year old black boy within 3 months or less period. If it is showing faint 2 red lines in the test what can be done to permanently remove and destroy the HIV virus before it becomes stronger.

A: If someone is found to be HIV infected, then HIV treatment would be indicated. The HIV treatment would be life-long and does not cure the infection. HIV treatment will prevent any damage to the immune system that the virus would cause though.

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PCR HBV VL DNA

Sun, 07 Jan 2018 18:03:52 -0400

Q: hepatitis b virus DNA VL 385 IU/ML, WHAT IS THE MEAN. IT IS NORMAL RANGE AND ANY ADVICE FOR IT

A: There is no normal range for HBV viral load, you are either infected or not infected with HBV. The assay range is from 20 IU/mL to over 100 million IU/mL. That results would be considered very low. You don't indicate if other tests were performed, so additional testing may be needed to determine if antiviral treatment is indicated at this time.

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Please my viral load is going high with me even taken my drugs wat do I do I don't want to switch to another drugs I prefer that once a day drug sir

Sun, 07 Jan 2018 18:01:31 -0400

Q: Please sir,my viral load is high and I don't want to switch another drugs because of my job status wat do I do to reduce it

A: You don't indicate what your HIV viral load and CD4 count results are, what the results have been previously, and what HIV regimen you are currently taking. Thus, it is difficult to determine the significance of your situation and what to do about it.

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Am I still undetectable?

Sun, 07 Jan 2018 17:59:39 -0400

Q: I just received my labs back. My previous bloodwork has indicated for years that I was undetectable. Havent talk to my doctor about it yet, but the recent one I received at the following results: 405 cpy/mL. Could just wait for my doctor to come back from vacation to tell me, but what change does this number indicate?Thank you!

A: Well that result would not be considered undetectable. Although you don't indicate what HIV meds you are taking, It would seem very unusual to see the viral load go from undetectable to 405, if you were taking your meds as prescribed and hadn't missed any doses. In general, we would just repeat the test. If the new result is again undetectable, then no worries. If the repeat is again positive at 200 copies or more, then a change in HIV meds may be required.

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HBV Viral load

Sun, 07 Jan 2018 17:56:14 -0400

Q: My HBV viral load is 1976 do I require treatment and can this be cleared.

A: You don't indicate whether any other tests were obtained and what those results are. That HBV viral load result would be considered very low. However, additional testing may be indicated to determine whether HBV treatment is indicated at this time. Yes it can be cleared with antiviral treatment.

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hep b viral load of 60,000.

Sun, 07 Jan 2018 17:54:44 -0400

Q: Is this serious? Dr wants me to start vimledy medication. What is the normal range for hep b viral load?

A: There is no normal range of HBV viral load. You are either infected or not infected. The test range is from 20 IU/mL to over 100 million IU/mL. Your result would be considered low, but as your doctor said, HBV treatment is indicated.

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TPHA:1:160

Sun, 07 Jan 2018 17:53:23 -0400

Q: Hello Sir,I am Computer Eng. few day ago,I go to donate blood my school teacher at a Hospital, Says my Blood are not pause in the patient body, because Shills are present on my blood and tested another Lab got same result, they got TPHA- 1:160. what can can I take treatment, please advice and recommend treatment.Best Regards

A: If you have a medical doctor you see or can make contact with, you should discuss your results with them and they will prescribe the appropriate treatment.

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Hb b viral

Sun, 07 Jan 2018 17:51:12 -0400

Q: Sir,my hb b viraul loadd is <3.7 positive this range normal or high, thanks sir

A: You don't indicate why this test was obtained, what other tests for hepatitis B virus infection were obtained and their results, and what the actual units are for the HBV viral load (i.e., actual IU/mL, or log10 IU/mL). Regardless, there is no normal range of HBV viral load, you are either infected or not infected, and that results would be considered a very low HBV viral load.

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me asking

Sun, 07 Jan 2018 17:48:52 -0400

Q: Doc what's the first thing to do if got a result of reactive vdrl and positive tpha? How to be treated.

A: Your doctor needs to determine the stage of infection, which then dictates the antibiotic regimen for treatment. I suggest you discuss this with your doctor.

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