I seem to be plateauing on my Therapy with Atripla. Whats up with that?

[ejwilliamson90]

My first reading before being on medication back in April was Cd4/89 vL 555,000
By July after about a month of being on therapy my cd4 was up to 125 and vL was at just 900
Then in September my CD4 reached up to 184, viral load at 90.
I went back a month later and much to my disappointment my cd4 had dropped to 170 but my viral load is continuing to go down It went down to 72. And my next lab reading a month later yielded almost the same exact results. I go back to the doctor in mid December and get my labs done a week before that. Should I be worried that I am plateauing and my cd4 may not rise anymore? I've added some herbal supplements and multivitamins in . I take a B complex with C, Ecchinachia, and One A Day mens.

My other medications are

Lexapro 20 mg
Ativan 2 mg 2x day with an extra dose if needed
Quinapril 40 MG
Zegrid Omazeprole BiCarb 40 Mg
Dapsone 100 mg
Trazadone
Ultrum 50 mg as needed for pain.
Also just a few weeks ago i had bi laterial hernia repair on my groin (fun fun) so i hope that doesn't hurt me!

The week after my surgery I was really out of it, and much to my dismay missed a dose of my atripla, took it the second I realized I missed it at 6PM, and then waited till bed time the next night to continue my normal time of taking it. My anxiety is often brought out by my HIV, and the fact that I am constantly stressed about my numbers.

Is it possible that I was just moving slow on my immune system recovery for a while and it could start going back up again? I'm just hoping they don't have to add another pill to the regimen........


Any advice or words of encouragement would be great....

Blessings!

Eric

[Matty the Damned]

Echinacea is an absolute no-no for HIV positive people. I'm not saying that has anything to do with your numbers, but you should discontinue it most rikki tik.

Is echinacea your only herbal supplement or do you take other things?

This is serious shit. Many herbal supplements are a problem for pozzers, particularly for those of us on medications.

Also welcome to teh forums.

MtD

[Assurbanipal]

My first reading before being on medication back in April was Cd4/89 vL 555,000
By July after about a month of being on therapy my cd4 was up to 125 and vL was at just 900
Then in September my CD4 reached up to 184, viral load at 90.
I went back a month later and much to my disappointment my cd4 had dropped to 170 but my viral load is continuing to go down It went down to 72. And my next lab reading a month later yielded almost the same exact results. I go back to the doctor in mid December and get my labs done a week before that. Should I be worried that I am plateauing and my cd4 may not rise anymore?

...!

The week after my surgery I was really out of it, and much to my dismay missed a dose of my atripla, took it the second I realized I missed it at 6PM, and then waited till bed time the next night to continue my normal time of taking it. My anxiety is often brought out by my HIV, and the fact that I am constantly stressed about my numbers.

Is it possible that I was just moving slow on my immune system recovery for a while and it could start going back up again? I'm just hoping they don't have to add another pill to the regimen........

...

Hi Eric

Welcome to the forums.

You are making great progress.  In 6 months your CD4 count has just about doubled and your viral load got to levels that was undetectable under the tests that were in use only a couple of years ago.

Try not to focus on small changes in the CD4 count.  There is a fair amount of random variation in that number; after all its not like they draw out all your blood and count every cell -- they are just taking a small sample (thank goodness!) and extrapolating from there.  Any one reading is only an estimate of the true number which is probably somewhere plus or minus 30% from that value.

Oh, and don't worry about missing a single dose of Atripla when you are almost undetectable.  Missing a dose in 6 months is pretty close to perfect adherence.  Just don't make a habit of missing doses and you will be fine.

So far you are doing great.  It is too early to worry about your Cd4 count plateauing.

Be well
Assurbanipal

[buginme2]

Hi Eric!
You started with a pretty high viral load of 550k.  Atripla is one of the best medications for those starting with a high viral load and it has worked quite well with you so far in reducing your viral load.  Sometimes it just takes a little longer for your cd4's to rise, especialy if you started with an initially low cd4 count as you did.  

I agree with Matty.  I have also read that echinacia isnt recommended for HIV positive people.  The one a day vitamin probably has you covered.  

Good luck, Be well!

[ejwilliamson90]

Oops on the ecchinachia.... I just started it like a day ago So I guess I'm in the clear. I even researched some to see if I was okay and didn't see anything wrong, but oh well....  Thanks for the words of wisdom, I guess its frustrating cause I've had friends respond even faster with their cd4. I had one who went from 180 to 600 in 6 months. So it's discouraging but I guess you have to count your blessings.

Again I appreciate it!

[eric48]

Hi and welcome to the forum

Please have a look at figure 3 page 4 of this article:

http://www.pnas.org/content/97/10/5393.full.pdf

(Long-term kinetics of T cell production in
HIV-infected subjects treated with highly
active antiretroviral therapy)

you will see that **statistically ** (i.e. for most people, not every one...) there is an initial CD4 increase of
+50 (naives) + 50 (memory) i.e. total 100, then a plateau for a few months then another 100 increase. and then , slowly, little by little, you'll catch up

These data where published with a patients startting with relatively low nadir (like your self)

your lowest known CD4 count (89) is 10 % of 'normal' media value of 880. It was damaged by 90%

Your expectations should set accordingly.

You will recover well enough to feel good !

Be patient and a bit carefull for the next few months

Cheers

Eric

 

[newt]

A normal CD4 count starts in the mid 400s, there's no way to know what number is relevant for an individual, could be higher couild be 400+.

Time is a great healer. HIV treatment needs to be thought of delivering immune restoration in years not months.

- matt

[SoSadTooBad]

It took me 6 years to get from 78 t-cells to over 600.  5 of those years on Atripla.   Be patient, dont skip doses, it will happen.