CD4 457 Viral Load 12,000-Doctor Placed me on Meds

[stefanocc]

I found out I was HIV poz Jan 2005. My original CD4 was 890 and Viral Load at 1974.  As of yesterday my CD4 is at 457 and my Viral Load at 12,000. My doctor advised me to get on meds now.  She prescribed me a mix of 2 Reyataz 200mg and 1 Truvada.

I'm a bit lost and sorta scared of the side effects. Anyone have any feedback if you are on this same type of cocktail?

Any information would be greatly appreciated.

Stefano

[newt]

Hello, welcome,

yes the spook of possible side effects...

I am on this combo (more or less, I use Reyataz + Norvir, see below) and have had no/minimal side effects.

US guidelines recommend Reyataz is used a small amount of Norvir when combined with Truvada.

One of the drugs in Truvada, tenofovir, reduces the level of Reyataz which may make it ineffective. The recommended formulation with Truvada is 300mg Reyataz + 100 mg Norvir (which is used as a booster drug and overcomes the Truvada/Reyataz interaction).

This website covers Reyataz in detail on this page:
http://www.aidsmeds.com/archive/Reyataz_1563.shtml

- matt

[stefanocc]

Thanks Matt. I did read all of the info regading the actual drug on the site. I wanted to get a feel of personal experience of those who have been on this drug.

[Sydney]

Hi Stefanocc,
I don't have any experience with these drugs (or any - though I will soon) - but if I were in your situation I'd be looking for a second, independent, opinion from a HIV specialist about startings meds this early - there would be pros and cons.  I'm fairly confident that, according the the guidelines my specialist doctor was following, he wouldn't have recommended my starting treatment with those figures (depending, of course, on other relevant clinical factors).  However, if I'd wanted to start, treatment would have been available.

Also, I presume you're aware that the absolute number of CD4s can bounce around a fair bit, and the percentage is a more reliable indicator of change? What was the change in percentage of your CD4s?

From one newbie to another, welcome.  It's a great site.  If you don't get a lot of replies, use the "Search" and that will lead you to previous posts around your question. I spent a lot of time doing this, and it was well worth while. 

[newt]

All well and good, I am sure people will chime in with their personal experiences to add to mine, which is, again, that this is, for me, easy and more or less side effect free from day 1.

If you've read the info on the drug I am sure you noticed this from the Aidsmeds write-up:

...if Reyataz is to be combined with Atripla, Truvada, or Viread, it must be combined with Norvir...

and perhaps from the manufacturer's package insert (http://packageinserts.bms.com/pi/pi_reyataz.pdf)

Dose Recommendations for Therapy-Naive Patients

REYATAZ 400 mg (two 200-mg capsules) once daily taken with food.

or

REYATAZ 300 mg (one 300-mg capsule or two 150-mg capsules) with ritonavir [Norvir] 100 mg once daily (all as a single dose with food) if combined with any of the following:

- tenofovir

...tenofovir being 1 of the 2 drugs in Truvada.

If your doc is insistent on use of Reyataz + Truvada without Norvir he/she is reducing your chance of this combo being effective by about 1/3rd.

- matt

[stefanocc]

Thanks for the information "Newt" and "Sydney". I appreciate your perspectives and feedback. I've got another appointment with my doctor in 3 1/2 weeks. I'll be sure to discuss.

Cheers!

[penguin]

dead easy combo it was for me. minor yellowing (reyataz); some stomach discomfort & a kinda wizzy feeling from truvada if i took without food/late in the day. otherwise no problem

random truvada experience - having airport security guy at mumbai sahar attempt to barter with me for my 2 week supply...somewhere between repeated questioning about from doctor, not internet?, and something about make wife happy, it dawned on me he was thinking of quite a different type of Little Blue Pill 

this being your first proper go at combo, you want to get this right - not using the norvir booster seems just a bit... daft.

good luck, adn welcome to forums - kate

[stefanocc]

Appreciate the feedback Kate.