Re: long term progressing to what?

[Guest guest]

I remember use of P24 antigen testing before PCR viral load tests were available. It was a short duration, but an improvement on T-Cells only. I don't recall if they were unusual or expensive, or "dissociated" P24 antigen.

I know it's all semantics, but I think of "long term non-progressor" as just that: "long term", but not necessarily "lifelong". This would apply to someone who doesn't show disease progression by all indicators. I think our different understandings of terms are causing disagreement where there really isn't any (except in the meaning of terms). Maybe "long-time non-progressors"? Still boils down to great value if we can find out why some people take decades to get sick, and why so far some haven't at all - even without meds.

I think your situation is pretty common, Dean. I ran for years with a viral load around 1,200. I've never been able to knock it below 50 for very long, and my T-cells have been all over the board. I do feel a lot better now than when I had a viral load of 550,000 and 50 T-cells - I was sick then for sure. The meds are causing more problems than HIV, like it sounds for you. Last winter I had a CD4 count over 800 - in the normal range for the first time in 20 years! It's back around 300 now, and the viral load is up around 750. I don't seem to be able to suppress resistance for over a year even though I'm religious with taking my meds. Individual situations, but I've heard the same from others.

Hang in there - It's good that we've only "progressed slowly" over the years.

BG

RE: long term progressing to what?

At 03:51 PM 12/10/2006, Dean Shaw wrote:

I'm just jumping in on this e-mail string. I have been POZ for at least 20 years, when tested, probably 25 really.. I have never been sick relative to my immune system. My T-cells live around 350, have dipped to 190 once that was detected. My viral load until recently on a new regimine, never stayed nondetectable -- around 1,300 2,400 copies; the highest was in the late 80's when in was 55,000. What category would I fall into -- long-time nonprogressor or slow preogressor? My cocktail makes to tired, but other than that I'm very healthy. Any input? Dean Slow progressor I'd say since your CD4 count dropped. And also you are on antivirals, yes?I think if there are long term "non-progressors" it means specifically that their CD4 count remains in the normal range for the duration of their lives. In short, no progression. I tend to place somewhat more weight on CD4 count than viral load in general--although, of course, a high viral load will generally correlate with a persistent decline in CD4 count. So clearly, both numbers are important.That is, while overall a low CD4 count is a not great thing, some people (a minority) seem to have compensatory immune mechanisms that help to prevent opportunistic infections from developing (e.g., possibly innate immune responses, natural killer cells, adequate CTL responses?) Others with higher CD4 counts may develop OIs anyway. But these are the exceptions and in general, CD4 count or percentage is the critical marker in terms of remaining healthy.One of the frustrating things for many is that these tests are largely unavailable in most developing countries. There are less costly alternatives for CD4 counting than flow cytometry (which is costly, requires expensive reagents and special training). Things like Guava technology, "manual" counts for CD4 and possibly dissociated p24 antigen for viral load. But these aren't yet widely instituted.That's another topic tho.... M.