ok – first let me say that I have been following this blog for many years (I would at least 9). Never have I written before but “know” many of you (especially long-term survivors). I always come here when I have doubts but also sometimes just to check how everyone is doing. :)
About myself: I am a “friend” of and live with a person with HIV (he also has HCV) who has had both of these conditions for many years now. He is 45+ and has had the conditions since when he was about 25. We live together. I love him.
Regarding my "friend"'s HIV condition, he has been on the same medications for 14 years: viramune + Kivexa (abacavir and lamiduvine). He was on treatment for a year before this but then stopped for another year (treatment interruption). The one year's combination included combivir, I think, and prior to that he had to stop a treatment because of anemia (o maybe it was the combivir that he had to stop as I know AZT can cause anemia...). In his 14 years treatment, he never had a problem (well, sort of – see P.S.); good CD4 and undetectable VL. His last CD4 (6 months ago) was 1200 31%. However, a test about 2 months ago showed a VL of 200 & something. The test was repeated to see if it was a blip (he had one other blip 6 to 12 months ago of about 400...) but it came back positive again: VL at 70. The doctor changed his viramune straightaway, as she said viramune can develop resistance quickly, and replaced it with Duranuvir and Indinivar. Now, on repeating the VL a month later, it was still detectable at 490. (All other results, except the Gamma, were within normal limit. CD4 will be retaken at next visit...Rationale for not taking CD4: Doctor said she was not concerned with it being stable for a very long time). About the VL, she was puzzled as were we ???. He is 99.9%, if not 100%, adherent; always has been and I had previously read these new drugs were quite good... So was/were very hopeful... But maybe it would have been better to change all medications instead of the viramune only? Doctor suggested to repeat the test in about a month and taking it from there. She justified it by saying that we might end up chasing numbers otherwise and was more relax in terms of these new drug's resistance profile... I think this is wise.
But what do you guys and girls think? Do you have any suggestions? Any things that you would do or ask at the next visit? Note that he was under a very stressful period copying with losses in the family :(; although the doctor said this should not have had an impact...
Ah, one more thing, she did run a resistance test but it come out negative; no resistance was found (but maybe there was just too little virus in the blood(?))
Sorry for the long message and thank you very much to you all in advance for your advice.
Clara Zetkin (not my real name...but a good one nevertheless, me think!)
*[[Well, no problem apart from high cholesterol (which he was able to manage with statins first and then by stopping smoking and eating better...still on the high side but not v. concerning) and a quite high Gamma GT. This is worrying. But he has had this high value for a very long time (at least 10 years. It was lower for a few years but now ranges between 500 and 600). He never had a liver biopsy – he does not want to do one... [I know...it’s hard sometimes but I have learnt to accept we all have different outlooks things...]) – but has had a fibro scan a couple of years ago which showed no fibrosis. He is due for another one in 2 months. All other tests within normal limits]].
Clara zetkin:
Hello,
me again. I know this is a tricky question... :-\ but anyone willing to put his/her own two cents in?
What would you do?
Thank you.
P.S. ah one more thing, when I said problems I, of course, meant blood test reading pr not physical ones...
Jeff G:
Hi Clara and welcome to the forum , Im sure somebody will come along and answer your question for you . I wish I could be of more help but this area of expertize is handled much better by a few other members who hasn't seen your post yet .
Im sure they will notice and give you the answers you seek soon .
Clara zetkin:
No problem. Thank you for the welcome and for replying to me Jeff.
I will wait patiently for someone to chime in...
Clara zetkin:
Hi all,
me again...I know...and will not post anymore for at least a few weeks.. ;).... But we really value your comments and would very much appreciate your suggestions before our next meeting with the HIV consultant (in about 4 weeks time).
Anyone willing to "advise" us?
Newt? (I am asking you because you seem to have really great knowledge about these type of things. ::) But of course we appreciate comments from anyone!! :)).