Start Treatment Now? Any advice?

[PiscesAries82]

Hello everyone,

I'm new to the forums(just signed up early this morning) so please forgive me if I seem like a newbie.....because I am. 

In mid December of last year, I went in for my annual physical with my primary care physician. That's when I found out I was HIV positive. My doctor then had tests done to determine my CD4 count and viral load. At that time, my CD4 count was at 430, and my viral load was at 14,000 per milliliter of blood. He told me I was still healthy, and that it would be years before I would need to start treatment. Last month I had my first specialist visit which we discussed a lot of things including treatment options. She explained to me that I do not have to start treatment now, although she strongly recommend that I do because the sooner the better. I agree with this, but at the same time I know that once I start treatment, I will have to take meds for the rest of my life. I'm not exactly sure if I am ready to have to remember to take a pill once a day, every single day for the rest of my life or until a cure is found. First world problem but I'm just being honest. Another thing is the side effects. I've done my fair share of reading some topics here and some of the stories are a bit frightening. I'm a bit OCD, and it is very important to me that my days and routines remain the same. I'm concerned that a side effect can possibly derail my day. Like make it difficult to work etc. My thing is that I'm all for starting treatment as I don't want to wait until my CD4 count drops dangerously low or my viral load skyrockets and I become more susceptible to opportunistic infections. At the same time, if I am healthy now why start treatment now? Aside from having high blood pressure at the age of 30, I feel fine. I exercise 4 times a week, and I watch what I eat. I've always done this, and didn't just start after finding out about my status. I don't do any drugs I just drink heavy on the weekends. I can knock out a 1.5 Liter bottle of chardonnay in just a few hours.  Today I go back to my specialist to discuss the results of my lab tests and possibly prescribed treatment. If I don't have a strain that is resistant to Atripla, I will go with that one. Can anyone offer me some non professional "know from experience" advice on if I should start treatment now, and what is the best med to take that has the least side effects? I will be forever grateful for any advice offered!

PiscesAries82

[buginme2]

All of the newer medications have very low/no side effects. So whichever you or your doctor decides on will be ok.  Be a little hesitant asking "what should I take?" From The forums, your likely to get a response of whatever meds the person responding is taking.  That's because most people are doing very well with what they have been prescribed.   You will be doing just as well too.

It's ultimately up to you to decide if you should start treatment.  Your cd4 is less than 500 so you meet treatment guidelines in the US. 

Taking one pill a day really isn't that difficult.  I've been on meds a few years and I think I've forgotten to take my meds once. 

With that said, there is sometimes a need to "get with the program time."  You have a disease that can kill you if you don't treat it properly.  Take it seriously.  If that means adjusting your lifestyle a little so you are ready to take your meds, then so be it. 

[mecch]

Hello
Have you ever had an OCD diagnosis? Psychiatrist or psychologist investigate that?

The thing with Atripla is that it contains efavirenz.  This can cause psychological side effects.  In a few people.  Most people have great experience with Atripla.  A few people get the "sustiva crazies" - rage, and/or depression, or anxiety.  Its something about how this component drug effects the CNS and the brain... 

I have no idea if OCD is a possible indicator, that Atripla could be a less than ideal choice. But I would mention that to the HIV specialist and see what they say.

Some HIV specialists do NOT like to give much truck to the "sustiva crazies" but its a very real side effect and people have had to switch off Atripla....   

In 2013, there is a big choice of first regimens.  I think anyone with a history of depression or anxiety is pretty wise to stay clear of Atripla as the first choice and HIV specialists for the most part know this....  I don't know about OCD, however...

 

[PiscesAries82]

All of the newer medications have very low/no side effects. So whichever you or your doctor decides on will be ok.  Be a little hesitant asking "what should I take?" From The forums, your likely to get a response of whatever meds the person responding is taking.  That's because most people are doing very well with what they have been prescribed.   You will be doing just as well too.

It's ultimately up to you to decide if you should start treatment.  Your cd4 is less than 500 so you meet treatment guidelines in the US. 

Taking one pill a day really isn't that difficult.  I've been on meds a few years and I think I've forgotten to take my meds once. 

With that said, there is sometimes a need to "get with the program time."  You have a disease that can kill you if you don't treat it properly.  Take it seriously.  If that means adjusting your lifestyle a little so you are ready to take your meds, then so be it.

Thanks buginme2. I appreciate your advice. 

[PiscesAries82]

Hello
Have you ever had an OCD diagnosis? Psychiatrist or psychologist investigate that?

The thing with Atripla is that it contains efavirenz.  This can cause psychological side effects.  In a few people.  Most people have great experience with Atripla.  A few people get the "sustiva crazies" - rage, and/or depression, or anxiety.  Its something about how this component drug effects the CNS and the brain... 

I have no idea if OCD is a possible indicator, that Atripla could be a less than ideal choice. But I would mention that to the HIV specialist and see what they say.

Some HIV specialists do NOT like to give much truck to the "sustiva crazies" but its a very real side effect and people have had to switch off Atripla....   

In 2013, there is a big choice of first regimens.  I think anyone with a history of depression or anxiety is pretty wise to stay clear of Atripla as the first choice and HIV specialists for the most part know this....  I don't know about OCD, however...

I've never had an OCD diagnosis, nor have I had it investigated by a professional. I don't believe it's severe as I simply enjoy having my day go without incident, and I like things in their proper places. LoL. I've discussed everything with my specialist, and she recommended Complera or Atripla. I decided to go with Atripla because it's what I was leaning towards in the first place. If I have any complications whether physical or psychological I will contact her immediately. I feel confident in my decision, and we'll just see how the next few weeks pan out. I appreciate your advice! Thanks a lot! 

[mecch]

I've never had an OCD diagnosis, nor have I had it investigated by a professional. I don't believe it's severe as I simply enjoy having my day go without incident, and I like things in their proper places. LoL. I've discussed everything with my specialist, and she recommended Complera or Atripla. I decided to go with Atripla because it's what I was leaning towards in the first place. If I have any complications whether physical or psychological I will contact her immediately. I feel confident in my decision, and we'll just see how the next few weeks pan out. I appreciate your advice! Thanks a lot! 

This second message comes after seeing your doc today, and discussing such things again?

Because in your first post, you said you wanted advice about side effects of different treatments.

Anyhooo, sounds like you are in good hands and moving quickly along.  Lots of people sure do like Atripla.  SO good luck with that.  If you notice any increased anxiety, mention it to your doc...   Best.