Tuesday, February 07, 2006

Counting my Blessings: LTNP

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I count my blessings everyday. I realise how truly fortunate I am to be healthy and to have the life that I have. Although I have been living with HIV for almost 4 years, my viral load and CD4 counts have remained virtually unchanged without medication. I am what the medical community refers to as a Long Term Non Progressor (LTNP). The probability of being a LTNP has been debated between 0.8% to 10% of all infected HIV individuals. It essentially means that there is no symptomatic progression of the disease and that despite being infected with HIV-1, I have not or likely will not progress towards AIDS. This effectively means that I can live a relatively long and healthy life without medication. This of course can change, as a true LTNP is generally only bestowed on someone who has lived 12-15 years with HIV-1 and remains asymptomatic. I am only a third of the way there.

Why am I discussing this? Well, there really isn’t a day that goes by in my life that I don’t think about the disease. One really can’t avoid it. It is with me, coursing through my body, and for whatever reason, I have been spared or given a chance to live a less intrusive life of drugs, medical visits, or sickness. Like I said, I count my blessings, and part of my introspectiveness is that I believe I have to take a role as an educator. Well, not so much an educator as a participant in society and to give back. I am not one to dwell on negative things or to cry over spilt milk. What is done is done, and the question should now be, what do I intend to do about the place I am in now. I have said it before, and I will say it again, the HIV does not define me. I define it, and how it will play a role in my life. Yes, it crosses my mind daily, but I do not (and will not) let it grab hold of my life and drain me of my future.

Of course having just said that, I’ve just returned from my Doctor’s office to get my Viral Load and CD4 results. I do this every 6 to 8 months now. I had originally done it every 3 months, but the doctor doesn’t see a reason, as I am asymptomatic with little change in my stats. I went into his office expecting my Viral Load to be higher and my CD4 count to be lower on account of me having a cold through December and again in January, but as usual the results were better than what I or my doctor thought.

To give you a quick tutorial, a viral load test is ordered when a patient is first diagnosed with HIV. The test result functions as a baseline measurement that shows how actively the virus is reproducing and whether treatment is immediately necessary. The same is done for one’s CD4 count (also known as a T4 Count). Both tests are done continuously through the life of an individual with HIV, whether or not they are receiving anti-HIV therapy. Retro-viral treatment begins or is discussed when a persons’ Viral Load is high. Viral load tests are reported as the number of HIV copies in a millilitre of blood. If the viral load measurement is high, it indicates that HIV is reproducing and that the disease will likely progress faster than if the viral load is low. A high viral load can be anywhere from 5,000 to 10,000 copies and can range as high as one million or more.

A low viral load is usually between 200 to 500 copies, depending on the type of test used. This result indicates that HIV is not actively reproducing and that the risk of disease progression is low.

A viral load result that reads “undetectable” means that the level of HIV virus in your blood is below the threshold needed for detection by this test. This is where I fall into, but this “undetectable” load does not mean that I am cured. In conjunction with Viral Load results, public health guidelines indicate that preventive therapy should be started when an HIV-positive person who has no symptoms registers a CD4 count under 200. Some physicians will choose to consider treatment earlier, at 350. The Centers for Disease Control (CDC) and Prevention considers HIV-infected persons who have CD4 counts below 200 to have AIDS, regardless of whether they are sick or well.

So, since my Viral Load count is undetectable and my CD4 Count is above 500, I have been bequeathed the title of LTNP. The medical explanation of why one is a LTNP is still under major research, but there are some theories. There is some suggestion that it has to do with one’s genome make up. I have been through a battery of medical research tests to provide data to the CDC, NIAID and other organisations, so that they can better understand how an individual’s genes or DNA can resist the disease. But honestly, despite the current research, no one really knows quite why some people progress quickly and others do not. Hopefully the information I provide will benefit research for a vaccine or for Anti-retroviral research. I can only hope and be optimistic that despite having this terrible thing that there will be a Vaccine soon. A vaccine may not help me, but at least I can rest easy then, knowing the virus will have met it's demise.


Snooze said...

It's true, HIV treatment has still so much that is unknown. Glad to read that your counts are so good, and that's great that you are willing to participate in research. It's amazing how many treatment advances have been made, and discouraging how much ignorance and discrimination is still out there towards people living with HIV.

epicurist said...

Snooze - there really is a lot more that is required in the research field, I agree. I hope over the next few years that those barriers in research and discrimination are broken down.

mainja said...

see, i like learning stuff. i always knew the term viral load (well, presumably not *always*, probably not when i was 4) but i didn't really know what it meant technically, i just knew higher not good.

i like learning. thank you teacher epi... *grin*

epicurist said...

Mainja - I actually find this stuff quite fascinating so am glad to share it. :)

Anonymous said...

Thanks for that information. It helps to know there are others going through the same thing.

epicurist said...

Anon - Always my friend. If you ever need information or just to chat feel free to email me.

St. Dickeybird said...

Epi, thank you so much for writing about your HIV-related thoughts.
It gives hope for me about other friends that don't talk about it.

Babsbitchin said...

Well written commentary and inclusion of your life and feelings. It's good for people to read this, it'll make them think. They might think and have compassion. They may think and acquire a threshold of understanding. They might think and realize...this is not a game.It is, I'm sure, not easy to expose your under belly in this manner but if you can help ONE, just one person, those words are more full of meaning than any textbook. I have Hep C and My husband has already died from it. My friends have AIDS/HIV and I watch as they suffer too, not just with the disease but all the bullshit that goes with it, stigma, hate, fear and I could go on and on. You know.I thank you for sharing this and I encourage you to continue to share. I also encourage you to continue to work out, eat right and live life like there may be no tomorrow. You take care and stop by and see me sometime. People say I'm crazy...I tend to agree! But I amuse myself!! Take care buddy!!

Anonymous said...




epicurist said...

Dickey - thanks to you for being a great friend. :)

Babsbitchin -Thank you for your words and kind sentiments!

Bear Cave - :) thank you!

stukingfupid said...

Very informative thank you!