Friday, March 16, 2012

The AIDS Alphabet: T is for T Cell and T Cell Count

The AIDS Alphabet: T is for T Cell and T Cell Count
For AIDS warrior and award-winning photographer Kurt Weston, T is also for Thomas Nyland (the subject of award-winning photograph "The Last Light") and Terry Roberts

T cells: Also called CD4 or T helper cells, T cells are part of the immune system cells. Their role is to recognize—and then coordinate attacks against—any foreign invaders like bacteria, viruses, or fungi.
T cell count: T cell count [or sometimes T count] measures an individual’s immune system. It is calculated per unit of blood. A healthy person’s T cell count can vary but it’s usually approximately one thousand (to twelve hundred). 

One cannot talk about T Cell Count without also talking about Viral Load:

Viral Load (VL): Viral Load measures the amount of HIV in the patient’s blood. Two tests—T cell count and Viral Load—measure the evolution and the stage of the HIV infection in a patient’s body. A low T cell count and a high viral load determine an advanced stage or progression of the disease. HAART regimens can keep the viral load at an undetectable level and the T cell count close to the normal range.

AIDS patients have to test and monitor their T cell count and viral load on an ongoing basis. The lower the T cell count, the higher the viral load, and the more serious health problems (more advanced stages of AIDS). But, with the advent of HAART medications, AIDS patients and their physicians can better control the disease. Nowadays an undetectable VL is the norm, a 'norm' that cannot take it for granted, though. But right after the introduction of HAART treatment, AIDS patients still have a depressed immune system. Doctors had to put them on immunotherapies to help stimulate their immune system.

I'd like to offer you a peek into the immunotherapy experience and much more, as told to me by photographer Kurt Weston, during our interviews for Journeys Through Darkness: A Biography of AIDS. Here's an excerpt from Chapter Seven: Seeing the Future (Life Without Va)

Hope to see you on 3/24 at NYC Rainbow Book Fair! As always, thanks for stopping by,
Alina Oswald

The new HAART medications have saved Kurt Weston’s life. Bringing his immune system to a level that doctors considered “safe” was another story and required additional work, time, and treatments.  When he initially started taking Crixivan, Kurt’s immune system was virtually non-existent; therefore the medication, no matter how powerful, could not be as effective as doctors would have liked. They decided to try to boost Kurt’s immune system using immunotherapy—a treatment used to rebuild an individual’s impaired immune system, usually involving the administration of several cycles of immune system stimulants, called immunomodulators. 
    One example of an immunomodulator is Interleukin-2, a substance naturally produced by the body to stimulate its immunity. When the immune system is compromised and deteriorates below a certain level, like in the case of HIV/AIDS or cancer patients, the body cannot produce enough necessary Interleukin-2 and doctors can then intervene and administer a commercial version of the substance in order to boost the body’s immunity. For AIDS patients, Interleukin-2 has the potential to halt HIV progression by maintaining the T cell count in a normal range for prolonged periods of time. Interleukin-2 can also be used for cancer treatment, to prevent the reproduction of cancerous cells.
    For two consecutive years, between 1999 and 2000, Kurt Weston had to go through several Interleukin-2 cycles as part of his immunotherapy. During this time, the photographer received the medication several times a day, five days per cycle, every other month.
    The treatment was helpful and definitely necessary, because the stronger Kurt’s immune system was getting, the better the new HAART medications could help him regain his health and allow him to live an almost normal life. But the treatment also had severe side effects, similar to the ozone therapy ones, including a hundred and four degree fevers and rigors. And because of these side effects, by the second day on Interleukin-2, Kurt started feeling very sick. On the third day, he was holding on to dear life.

    Doctors had to prescribe several medications to control the side effects and help him complete the treatment cycles. Kurt ended up taking demoral, a powerful pain medication that knocked him out, and also various over the counter pain killers, like aspirin, for the rigors. After each Interleukin-2 cycle Kurt was going through several days of convalescence before he could start feeling better and getting on with his life again, only to resume his therapy a mere month later.
    Kurt Weston survived the treatment and, two years later, he completed all the required immunotherapy cycles. As a result, his immune system eventually started to get better and his T cell count soared from three to six hundred seventy. CMV was again inactive in his body, yet the damage the virus had caused in his eyes was permanent.
    To this day, in order to maintain whatever sight he has left, the photographer has to put daily prednisone drops in his eyes. The drops burn his eyes but allow him to continue photographing and creating visual art. 
    Previously, the disease had forced Kurt to reduce his life to bare survival. The new antiretroviral medications—the HAART regimens—started giving back not only his health, but also the chance to live his life once again, more fully. So, shortly after his graduation from the Institute for Junior Blind, Kurt started going out again using the ACCESS public transportation. He could resume attending the Positive Friends meetings and get back in touch with individuals he’d originally met there.
    It was during these meetings that he met Thomas Nylund, a historian with a special love for Roman Catholic history and theology. Thomas, who was several years older than Kurt, had AIDS and hepatitis. He continued teaching history until he got really sick and couldn’t do it anymore. Thomas became an ordained priest in the American Orthodox and Catholic Church, which a lot of people did not recognize as a valid religion. But Father Thomas—as people came to know him by—always took it seriously. He had a great photographic memory and was one of those people who would give a two-hour answer to the seemingly most insignificant question he’d be asked.
    In time, as they started to know each other better, Thomas started, ever so slowly, to take Va’s place. He started driving Kurt everywhere the photographer needed to go and was everywhere Kurt was. The two became great buddies and even talked about renting an apartment together. They ended up living right across the street from each other. 
    The photographer appreciated everything Thomas was doing for him, and although Thomas would have liked to take Va’s place on a more intimate level and to become Kurt’s partner, the photographer, as amazed as he was by his friend’s intellectual abilities, wasn’t interested in taking their relationship to the next level.
    By 2000, Kurt’s health started to improve and he became more accustomed to getting around and more familiar with the rules imposed by his vision limitations. Yet, he still had problems seeing people and, therefore, meeting new people. In addition, because Thomas was always around, the two were always together, sometimes giving the false impression that they were a couple.
    That year Kurt decided to join a workout group, which was organized by the AIDS Service Foundation (ASF) in Orange County. Because he and Thomas always arrived to the gym together, nobody in the workout group really made any serious attempts to connect with either of them.
    There were many people attending the gym. Some of them were senior members, while others were newcomers. Although it was difficult for Kurt to distinguish people’s faces clearly, he became aware of a particular new member who started showing up at the gym on a regular basis. Occasionally eavesdropping on the new guy’s conversations with others in the gym, Kurt concluded that the man of his interest had to be a nice guy. Yet, when Kurt tried to approach him, the mystery man’s face would turn beet-red and he would walk away. “He wouldn’t talk to me,” Kurt recalls. “He was non-conversant.”
    The photographer found out that his name was Terry Roberts and wished he could break the ice and talk to him, but he wasn’t quite sure where that would lead because Terry kept coming to the workout group with another man, a friend of his, and Kurt didn’t know if they were in a relationship or only buddies. Months later, when they started dating, Terry confessed to Kurt that because he always saw Kurt and Thomas together, he also assumed that the two were lovers. Terry also pointed out that the workout group was not their first encounter…
    At the time, Terry was on the Board of Directors of a small local AIDS support group, fighting to get some of the Ryan White funds. And for that he had to attend the HIV Planning Council meetings, the same meetings Kurt was attending in order to ask for federal funds necessary to continue the vitamin coop program he had initially started in 1996, when he was still a newcomer to Orange County and to the AIDS Service Foundation.
    Although he noticed Kurt at the meetings, Terry had never tried to personally introduce himself to Kurt or to contact the photographer in any way. But it seemed that fate was giving both men a second chance. 
    While at the gym and despite his shyness, Terry still wanted to get to know Kurt better, but he wasn’t ready to do it all by himself. So, he decided to invite the entire workout group for a Labor Day BBQ party at his house. At the time Terry had moved back in with his parents to help his mother care for his father who had Alzheimer’s. So, he planned and put together the party and told his mother about Kurt, eager to hear her impression on his potential future date.
    It turned out that Terry’s mother liked Kurt and gave the future couple the thumbs up. Meanwhile, Kurt didn’t have the slightest idea why he was invited to the party or the real reason for the party itself. After all, Kurt barely knew Terry or anybody else at the gym. In retrospect, the photographer believes that it was actually his dog who gave him a sign that Terry was, indeed, “the one” for him.


  1. I like your blog very much as you are propagating AIDS awareness through images and blog. Keep posting such kind of information always.
    photo calendar

  2. This comment has been removed by the author.

  3. Hello again,

    Appreciate your comment and I am touched that my blog speaks to you in such a way. I am truly humbled. Your words are proof that all the fight, messages, words and pix are not in vain. It's extremely rewarding to know that. With your comment, you give me courage to continue and I cannot thank you enough for that... because sometimes it's hard to stay motivated enough to keep spreading the word when nobody (or not many, really) is interested in what you have to offer. But I guess there are people who are interested. So, thanks a million and hope you'll visit often.

    I can truly say that your comment made my day and weekend! Appreciate it and will check on your posts, too :-)


    PS: I had to repost the comment, wasn't sure I got your name right. That's why. Thank you so much for stopping by, reading my blog AND posting a wonderful comment! I much appreciate it and hope you visit soon :-)