acute infection and early start of therapy

[hivtalian]

Hi everyone,
I just joined this community as I was diagnosed 1 month ago and after several very hard days, I decided to start fighting, which also means sharing questions and experiences with people like me.

I'm a 40 yo guy from italy.

After having talked with my hiv physician, I decided to accept to be included in a trial for an early treatment in acute patients (it means infection got no more than 10 weeks before - I had an acute retroviral syndrome last month) . I found on the net that the latest papers on hiv therapy suggest an early treatment for acute patients and I actually agree: the idea of a virus colonising my body and me letting him do what he wants was psychologically killing me. I had to do something to fight, and I did.

I'm on ISENTRESS+ TRUVADA+ NORVIR+ PREZISTA since 10 days and I'm having blood samples taken every week since end of december. So far, fortunately no acute side effect was seen, it seems like I'm swallowing candies

my cd4 were 590 on 12/27/13, vit virus 560000
                  716 on 1/8/14, then I started with pills and
                  766 on 1/10/14.

The question is: has anyone been or is anyone in the same situation i.e. early treatment with high cd4 at start?
I'm quite feared about long term side effects, being a fit guy working out since 20 years already, always concerning about my body and face, and the idea of something seen on my face scares me a lot..
does anyone know about the "safetiness" of this association?
I know that side effects are different among people, but some personal advices would be very appreciated..

Thanks a lot to everyone and well...good luck:)

PS sorry for my english but it's not my mother language

[mecch]

I was diagnosed in acute infection, but started about 3 months later. Still with a very high viral load.  I did fine in the long run. I think its been 5 years since.

I'm sure you're doing a good thing for your health.

I'm no expert so I was just wondering why you are on 4 antivirals instead of 3...

Welcome here!

[eric48]

I'm no expert so I was just wondering why you are on 4 antivirals instead of 3...

Hi and welcome to the forums!

I have seen this happen several times... I 'think' the rationale is that when you treat as soon as tested, you do not have the results from the resistance test to make a proper decision.

Most likely one molecule will be dropped sometime

hope this helps

Eric

[hivtalian]

yes, that's the reason, my doctor said I got this therapy because I still don't have the resistance genotype results, that I should have next week, then we can see. This is, at least in Italy in my hospital, a new study on acute patients and I decided to be included because I really think an early therapy is the best you can do to block the virus from entering in all your cells as soon as you can, of course if the infection is diagnosed early
.
My bf, who infected me, and then is in a subacute-recent infection (he got it kind of 3 to 4 weeks before me) is waiting for his resistance test (next week also) to start the therapy, because for his timing was not included in acute infections protocol.

I'm kind of feared because since yesterday (i.e. 10 days after I started) I realised I have some very small red lumps/ rush in my arms and chest, painless and itchless... Could it be an acute side effect? I hope it's gonna go away by itself and I'm not gonna be invaded all over my body :/

Thanks guys it's always nice to feel you're not alone.

[xinyuan]

Let your doctor know as soon as possible about the rash.

S/he will let you know if it's a concern.

Don't stop taking the meds without checking with your doctor first.

If the rash gets worse, get it checked out immediately.

Regardless, let your doctor know.

[buginme2]

Hey

1.  Don't worry about meds affecting how you look.  A lot of us workout every day and you wouldn't know by looking that they have hiv.  Those fears are mainly leftover from earlier meds that aren't used anymore.

2.  It's pretty common to get a rash when starting meds.  It usually goes away on its own.  If it's mild, take a Benadryl or something similar. 

Sounds like you have everything under control.  I doubt you will regret your decision to start meds right away.  It's what I would do too.

[hivtalian]

Thx guys!
This morning I've been to my dr and she said the rash can be the effect of the drugs on the skin immune system, not necessarily an allergy, even because it's not itchy nor so big. She said to take an anti-hystaminic pill and in 2 days I'll go to see her again.
I really hope this will disappear because apart from this I'm tolerating very well my pills, and my cd4 went up and virus down (920 cd4 and 4000 viremia, starting from 716 and 560000!)

I'll keep you posted! let's cross our fingers!

[wolfter]

Welcome to the forums.  I too wonder why you're on such an extreme combo.  I believe a couple of your drugs contain the same components thereby doubling your dosage.  I might be incorrect and I hope some of the our better versed members chime in.  I'm on a very similar combo because of sever resistance issues.

best wishes
wolfie

[Ann]

I believe a couple of your drugs contain the same components thereby doubling your dosage.

Nothing is doubled in his combo. He's on two different NRTIs (Truvada = tenofovir and emtricitabine), one (boosted) PI (Prezista + Norvir - this combo really only counts as one med) and one Integrase Inhibitor (Isentress).

Unless he has resistance issues we don't know about, he'll probably be changed down to either Truvada, Prezista and Norvir, or Truvada and Isentress at some point in the near future. As Eric mentioned, he's probably been put on an extra med as he was put on meds before his resistance test results were back. Better safe than sorry.

Italian, welcome to the forums. Your numbers are going in the right directions and you're going to be ok.

Ann

[hivtalian]

thank you guys, and thank you Ann, it looks like you're one of the bosses here !

Actually it's true, my doc told me in the near future I'm gonna change combo, and this tough start is because I have to wait for virus genotype and resistences. Another reason is, she said, because in the acute phase there's the colonisation of all tissues by the virus, and these drugs have not only an effect on the virus in the blood but also in the gut, where there is an immune system that once is destroyed by the virus is then impossible to restore, unlike in other body areas. So if this tissue is saved from the invasion, in the future it will be easier to keep my cd4 high.
At least that's what I got:)
I really trust her and what she says, she's one of the most scientifically active in my hospital, she always tells me about all the papers written on the subject and really believes in an early haart start if you are an acute patient.

The rash I had, after an antiistaminic pill, looks better, hopefully it will be gone in few days.

PS this morning I got the results of the last blood sample:
 CD4 920 and viremia 4000! It looks it's working )

[Ann]

Your doctor's reasoning is spot on, so it looks like you're in good hands.

Good to hear your rash is getting better. Make sure you drink plenty of water - it will help.

Nice numbers!

[hivtalian]

hi everyone, just to say that my rash almost disappeared and this morning I had a new blood sample...
I'm feeling much better:)

thank you very much for your support:)

[eric48]

... Ann, it looks like you're one of the bosses here !

LOL . Italians have a natural gift to find out who is the real Godfather.

Just kidding to provide good mood

Italian, thanks for the good news : we were sOOOO woRRRRRRied

Again, Just kidding to provide good mood... You've make the right decisions and you'll be doing fine

Cheers!

Eric