HIV meds

[snoofle]

So my boyfriend had been acting a bit distant and off lately and he finally told me that he had went to his HIV doc last week and while his CD4 went up a little bit (didnt specify) from the initial 250 he was at and his VL is still undetectable, his doc wanted to add Viread to his current regimen of Truvada and Kaletra. He was feeling upset, b/c he was thinking he was going to die sooner since he was having to take more meds and was worried about resistance to it. Now I am worried about the resistance portion as well. He was on Combivir and Viramune first and was reallllly nonadherent to it, and was switched to Truvada and Kaletra fairly quickly. Now, he has only been on Truvada and Kaletra for maybe 2-3 years and I was hoping this would be a more longer term regimen for him  I have heard of people being on some combos for years and years and years and I guess, while I shouldn't worry too much since his CD4s did go up a bit, it still concerns me. He isn't like 100% adherent person on earth though and while I constantly nag, he doesn't always listen. But I'm hoping the fact his CD4s didnt go up as high as his doc wanted and the adding of the new med is just a result of him missing those few doses and this will jolt him into being really adherent. 

[Assurbanipal]

Hi Snoofle

Just wondering if you are sure that he is adding Viread to his combo or if maybe it was something else?  I'm on Truvada/Kaletra too.  Truvada is actually a combination drug that already includes Viread and Kaletra tends to increase the blood levels of Viread so that there are special warnings to monitor people on this combo for kidney problems.  Adding more Viread would raise those risks and the drug label for Viread says it should not be used with ATRIPLA or Truvada.

Best
A

[J.R.E.]

Hi Snoofle

Just wondering if you are sure that he is adding Viread to his combo or if maybe it was something else? 
Best
A

Yes, you need to get this sorted out. Truvada ( as already stated by Assurb, has Viread in it.
Somethings not right, or was misunderstood.
http://www.aidsmeds.com/archive/Truvada_1584.shtml

Ray

[WillyWump]

ADHERENCE, AHDERENCE, ADHERENCE!

No med will work as it should for him unless he works on his adherence.

[physicsguy]

He isn't like 100% adherent person on earth though and while I constantly nag, he doesn't always listen.

Nag more.  Non-adherence is worse than not taking the meds at all.  Here's a handy graph that highlights just how important adherence really is:



Non-boosted PI regimens require extremely high adherence to avoid virologic failure.  As for the viread thing, make sure you get this straightened out.  It should be ritonavir, which is actually a component of Kaletra.

[Stone]

Hi!  As a nurse, dealing with people skipping medications is something that I deal with every day.  Couple things that I have found helpful to increase compliance:

1) Point out that he is not taking medication because he is sick, rather he is taking medication because he is healthy and wants to stay that way

2) Try to find out if he is not being compliant because he is having problems with side effects

3) I know this may seem counter intuitive but try to stop nagging all together.  Sometimes the issue just turns into a power struggle.  Also, by you taking so much of the responsibility he is relieved of taking any.  I had to do this with my brother a couple of times and let me tell you it was really hard.  My brother would fall asleep at night in a chair in the living room, twisted up like a pretzel, contacts in, and not having his meds.  Then the dance would begin.  My other sister and I would start waking him up every 30 minutes or so to try to get him to at least take his medication.  Generally we would be wanting to go to bed ourselves, but because we also wanted to make sure he took his meds we would be up for another 1.5 - 2 hours.  Now he gets one time, two if I am in a good mood.  I tell him that he needs to get up and I am going to bed.  Before I would be so frustrated that I wanted to choke the life out of him when he finally got up.  Now, I think he actually gets up sooner and I am not risking jail time  . In a way it also makes him more likely to listen to me when I am getting after him about something else.  I try to make sure that I really need to (hence my other post) before I say anything and I try to stay out of nag mode.  Not always successful on either count mind you but I do try