People with low CD4 counts are at risk of death after starting ART

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This is a good reason for you to test for HIV

Being with CD4 low can lead to death, even if it starts soon after initiation of HAART is a palpable possibility in late diagnoses

REALITY study shows that people with very low CD4 counts are at risk of dying soon after starting ART

A note from the editor. I translated this text with my heart in my hand and it was revised in the same circumstances.

What I've noticed is that this "premature" risk of death occurs among those with advanced CD4 cell count decline. And I could not remember the myriad of people who are searching for ZAP with a HEMOGRAM IN THE HANDS, THAT AFFECTS *** LOW LEUCOCYTES **** AND THAT DESCRIBE ME THIS REALITY WITH THESE MEMES IN SEQUENCE 😞 😞 😞 😞 😞.

It's as if they look at me and ask me, tacitly:

- "Do not make dodges, I'm screwed right?

There is a risk of death with a low CD4 count, even shortly after starting ART

And it is at this moment that I miss a remote electroshock device that would allow me to give electric shocks from a mere volt so that these people would recover their attention and try to understand that, yes, leucocytes are white cells, but not all of them are affected in the process of immune loss and, it is important to stress, the cells that dramatically determine the AIDS condition - It is the last time that graph this word in this form. Hereafter it will be AIDS that defines what is the basic disease caused by HIV which reads like this:

Acquired Immune Deficiency Syndrome (note that the latter term determines specific condition because there are, for some transplanted persons, recurrent problems of risk of rejection, immunosuppression induced by immunosuppressive drugs whose names I will not seek to know not to feed human fires.

Syndrome, in medicine, is a set of symptoms (I hate this word) and signs. And before the autarchic comes to ask me where I got this, I teach you, the few that could not know, is that Google's search box has other functions, such as calculating and a very interesting that is "DEFINE" . The syntax is simple and you type define: word.

Example: define: commentator to no avail

And the answer will come with something like autarchy

In case I put it here:

CD4 low count
Google image

 

 

This syndrome, acquired immunodeficiency, has as signs and symptoms epidermal, carcinogenic manifestations (cancers development) atypical manifestations of diseases generally well known in other organs, such as tuberculosis, miliar, cerebral or bone, among other TBs, or a manifestation of Sarkoma's sarcoma common among older men in, say, a forty-seven-year-old woman and many other opportunistic diseases. Why opportunists?

Well, what I've learned is that we, the entire planetary biome, have earned the right to live here through a process that shows God's Patience, Wisdom and Love for His creation and even gives ample news of His holy patience (Job, lend me some), through a process called "Evolution."

There are certain microorganisms that are so prolific that it is impossible to remain untouched by them and their invasions and attacks on our "Organic Cosmos" (like this expression).

I will bring here a passage from another page, which deals with a sad illness called Mycobacterium Avium Complex

If you click the image it will open the whole story in another tab.

Why the heart in the hand?

I have been accompanying people who have been going through the complex times and I am confident because, in fact, I trust in medicine and, even though my heart is tight because of my daughter, I am working because I am insomnia and , I said…. I have to remain loyal to myself and to my words, to serve God and to espouse His designs, though not apathetically, for I have preached to so many that "All is as God desires" and now God is asking me about how I feel in this regard:

"Terrified."

I love this girl and lose her, it would have been as if everything in me were over. But I said to my third Daughter, "Go .... nothing is in vain "

And so, while I wait for the phone to ring, or not, I am lining up these words so that you understand, and I repeat the whole sentence. AIDS is not a disease that manifests itself in two weeks after being infected with the virus and, it is said, is so authentic that, it is now known, it is possible to avoid that the organism that came into contact with HIV does not allow the establishment of the infection if at most 72 (but look PEP maniacs ...) hours, you start post exposure prophylaxis and take draconian, spartan or religiously.

So, find out from this idea that HIV equals Ebola: Hit, fuck.

The development of AIDS is a long, gradual, gradual process, it is often allowed to remain even longer for a longer time, but the fact is that in a "normal" adult (from a biological point of view) it has a CD4 count that oscillates between 500 and 1200.

I remember reading one of these magazines that today, not even to lip the dog's poop, which said that when the count of CD4 reached the 500, it was the beginning of the end. And I was with a little less 370 ....

What happens is that the body, attacked by HIV and without receiving any support is recovering what it loses and, frankly, I am not sure why, from an uncertain moment, the body begins to lose this race and the mean CD4 cell loss is 80 per year ... +/- ....

But your leukogram will not say anything about it, because CD4 is not a cell, CD4 is a chemical receptor with specific functions that unfortunately fits with a receptor's protective HIV protease layer and this allows these cells, which has this receptor, are invaded by HIV that starts, and I'm not going to stretch out around here, do your dirty work, "and if you, who fuck without a condom, or wear shares of injecting drug use, or who do the fingernails in Malévola's Manicure, where the last time we spoke in an autoclave there was a burst of laughing cigars not being constantly tested (I would advise, if anyone asked me for this advice), even married women would do this exam at least annually and keep a good pasta stick in hand.

Testing is free. It's fast, stealthy and safe.

And, I know, it's scary.

But it's just scary because you, OH sero-interrogators, are living in that hideous belief that HIV is something of "people who do not pay." Speaking of which, what the fuck is this one of people who does not pay.

I know, I know, there's a certain plateau ...

There is life with HIV!

I received my diagnosis with 30 for years! There was no treatment. They gave me six months of life ...

My Maroca ... Almost 29 living us "with this" ...

What is the fear of you?

The prejudice?

It's ... That's right, most of the time. You tell me here, and I will not repeat cruelties, for you say you fear for yourself what you yourself believe, that people with HIV are and deserve. You come to me and look at me for fear of me being a "mirror".

Not?

YES! YES! YES!

It has a very interesting case (I treat as a case what is actually a pattern and husbands who betray their wives (God knows why) when they are pregnant and they come on a page that is between "the most, most of the site: How long does an HIV-infected person take to transmit the virus? "

This is because the person needs to know what to do, because you can not risk the person you love (I understand extramarital affairs as a facet of life like any other) to contract HIV and do not know what to say to the person for how in the sonnet: "Suddenly, not more than suddenly!" having to use a condom!

Some of them, or them, ask on behalf of a friend and I respond with the link.

And there's a lot of talk and then the guy came out with something like this:

- "I worry about my wife and my daughter, who is about to be born". They say and then the assault

"Fuck me! I deserve!

It is implicit and explicit that I deserve to be fucked!

And yet, this site / blog is actually my personal response to HIV infection!

 

But, in the articulate opinion (the worst of all) I'm here, I'm "SO" because I LIKE.

Maybe this is true, if told by me, to me, based on what I know I was.

So. You deserve less.

The other day I watched a very elucidating episode of the serious Lucifer, on NETFLIX: "A Father enters the bar."

And the girl inadvertently confesses and her libidinous thoughts about the driver and Lucifer urges her to vent their fantasies because, after all, within our system (the Catholic), after the error, it was enough to go back to church, confess his sins, he had paid "penance" and everything "is in order".

 

INTERESTANTÍSSIMO, I would say, if you invited me to say, but do not invite me ....

 

And if they seek so much merit, do not do as it was done to a friend of mine, who left us 14 years ago and I still have not been able to recover from her sarcastic humor:

"Ah! Claudio! Do not tease me !!!! I'm Blonde ".... Amarilis (in Memorian)

The shortest way to not give a franchise to this mortality is to have safe sex, as I saw in an excellent AID prevention spot on MTV

Fuck, but do not FUCK. Use condom.

 

And if you hesitated, run and try the PEP, if you did not give the time, do the first test, to know if you are already a carrier and, if so, warn your risky contacts. If it is not, well, wait for the immunological window, invent a religious ritual (that's all you needed to explain the two months without sex).

If the examinations come unreactive, read this and if you can, make a deposit, support this work because while I was writing I did not think of my dear daughter.

In which favela will be.

Nodes, as they say, are treated like garbage.

If despair hits, she makes a "$ 5,00 program" for another stone ...

😭 😭 😭 😭 😭 😭 😭 😭 😭 😭 😭 😭 😭 😭 😭 😭

And they certainly did not use a condom. This is the speech of my newly adopted third daughter

 

Mortality in people with low CD4 cell counts at the time of HIV diagnosis is associated with a number of risk factors including a high number of symptoms, weight loss, poor mobility, self-care problems, and some abnormal laboratory findings.Infectious Diseases Clinics. The study found that questions about fever, vomiting, weight loss, mobility, and ability to wash and dress up identified people with especially high need to start treatment on the same day.

The study involved people in sub-Saharan Africa who had a CD4 cell count below 100 cells / mm3at the time of HIV diagnosis. There was a high mortality rate during the first 48 weeks of antiretroviral therapy (ART) and the researchers identified several groups of clinical and laboratory characteristics that were associated with increased mortality risk.

Treatment guidelines now recommend ART for all people regardless of CD4 cell count. But between one-fifth and one-fourth of people in sub-Saharan Africa have severe immunosuppression at the time of HIV diagnosis and should be prioritized for early initiation of treatment and other interventions to prevent opportunistic infections. Any delay can be fatal; approximately 10% of people with very low CD4 cell counts die within three months of starting ART. In the absence of a CD4 cell count, or if the results of laboratory tests are delayed, health professionals need to know who is in particularly urgent need for antiretroviral treatment and other preventive treatments.

Researchers from the Eary Reduction The MortaLITY (REALITY) trial wanted to verify whether mortality during the first 48 weeks of ART was associated with specific groups of clinical and laboratory characteristics in people who were also severely immunosuppressed at the time of HIV diagnosis.

 

The REALITY study was a prospective clinical trial of ART and advanced antimicrobial prophylaxis in adults and children aged five years and over. Participants were recruited from eight centers in Kenya, Malawi, Uganda and Zimbabwe. All had a CD4 cell count below 100 cells / mm3at the time of diagnosis and started immediate ART. Half of the participants were randomized to receive antimicrobial prophylaxis and HAART, which included the addition of raltegravir as a fourth medication in the first 12 weeks of treatment.

o   primary study analysisshowed that increased microbial prophylaxis significantly reduced the risk of death after initiation of antiretroviral treatment.

In this analysis, subjects were assessed at baseline for risk factors potentially associated with increased risk of mortality, such as weight, grip strength and body mass, social factors, including self-care, symptoms, and laboratory abnormalities.

The researchers performed an analysis to see if groups of specific risk factors were especially associated with mortality risk, regardless of CD4 cell count.

During tracking, a total of 203 people (12%) died. Mortality was independently associated with advanced age (p = 0,002), lower CD4 cell count (p <0,001), lower albumin (p = 0,001), lower hemoglobin (p = 0,01) (p = 0,03), fever (p = 0,04), vomiting (p = 0,005), and problems with self-care (p = 0,001).

Taking enhanced antimicrobial prophylaxis was associated with reduced risk of mortality (p = 0,02). The results did not differ according to the use of raltegravir.

Several phenotypes - groupings of risk factors - were associated with a higher mortality risk.

The highest mortality rate (25%) was associated with a median CD4 cell count of 28 cells / mm3, a high burden of symptoms, weight loss, poor mobility and low albumin and hemoglobin.

The second highest mortality rate (11%) was observed in people with a group of risk factors including a mean CD4 cell count of 43 cells / mm3, weight loss and also blood test results indicating inflammation or underlying infections such as blood cell counts and abnormal platelet and neutrophil counts.

A third group of individuals with a mortality rate of 10% had an average CD4 cell count of 27 cells / mm3but had a low burden of symptoms and maintained fat mass and body weight.

Mortality in the rate in the remaining people was between 4 and 6%.

"Instead of the late presenters being a homogeneous group, we identified 5 phenotypes, with several prognostic factors varying substantially between groups, as well as mortality," write the authors. "Screening patients with low CD4 count at baseline for significant weight loss, a small group of symptoms (eg, fever and vomiting), impaired activities of daily living, and a simple grasp assessment can identify those with higher risk of death. " With these characteristics, should prioritize ART on the same day and improve antimicrobial prophylaxis, researchers recommend ...

 

Michael Carter

Released: 05 April 2018

Reference

Siika A et al.Late presentation with HIV in Africa: phenotypes, risk and risk stratification in the REALITY trial. Clin Infect Dis, 66 (Suppl 2): S140-46, 2018.

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