Still not UD after 1 year

[Kalel]

Hi all, I've being reading this forum for so long, but never posted. 

I’ve being taking my meds for around a year now, never missed a single dose (maybe got some a little later, like 3 hours). And even so still not undetectable. (Lamivudina + Tenofovir + Efavirenz)

For me it’s really a easy going, no side effects, I drink and have parties once or twice a month, I fell healthy and my CD4 is perfect. My only complain is how my virus seems strong against my treatment.

Not sure if I should search other doctor or still trust this one, I really like him, and my CD4 is doing very well, but is taking soo long for me to get undetectable.

Even now to get the resistance test i would need around 1000 VL, and I’m only 124 now.

07/13 - Probably infected

Date   - CD4    -   VL
08/13 - 594     -  469.956 (start meds)
09/13 - 992,6   - 4.913
12/13 - 966,9   - 3.393
02/14 - 749,1   - 1.441
04/14 - 850,6   - 343
06/14 - 1158,6 - 124

He always says: “I’m pretty confident you will be und. on next exams, it’s taking long, but you are healthy, you don’t need to worry. Other meds are not as good and easy to take as these ones. Relax for now”

So… I wonder if I should get worried or still trust him.
I'm very worried about getting resistant to these meds... it seems other meds available here in Brazil are not as "simple" as these ones. He mentioned i would need to keep them on a fridge and take 3 times a day. (not sure if he said those things for me to not skip any meds)

[leatherman]

still trust him.

^^ that

it took me 6.5 yrs on my current regimen to reach and retain UD - which means don't freak out if you get to UD and then the next test bumps up too one hundred-something and then back to UD. CD4s and VL counts by themselves don't mean much and are not straight line functions. It's always about the TREND over 3 tests done over a 4-12+ wk period.

Your cd4s are incredible and 500 used to be called "undetectable" just 5 or so yrs ago. Clearly you are NOT becoming resistant because the numbers are still going the right way.

so trust your doc

[Kalel]

Thanks leatherman!!
Good to have an opinion of someone who lives so long with it.
I'm still getting used to it, but it's not as bad as we hear of before having it.

Will wait and hopefully next exams will be UD 

[leatherman]

Will wait and hopefully next exams will be UD 

I would think so. When you going next? Aug?

[MadisonTeddy]

"I drink and have parties once or twice a month,"

Does that mean using drugs? How often and how much are you drinking?

[leatherman]

Does that mean using drugs? How often and how much are you drinking?

pluh-leaze. That has no bearing on how some people reach UD slowly and some quickly. It's not just the meds, it's about genetics too. Take your silly prudish notions elsewhere 

[Kalel]

Drink around 3 or 4 doses of vodka with some energetic, or beers...
and Sometimes use ecxtasy, but this is like once every 4 months..

I know I shouldn't but I read a lot about it..
It could affect my CD4 but, last month I used both and my CD4 got even Higher, so just try not to exceed and give time, food and gym for my body to recover well after it.

[Kalel]

I would think so. When you going next? Aug?

Actually September, always get a little nervous days before the exam, that I don't think will ever change.. 

[eric48]

It took me one year...

As long as it keeps going down,it is OK

[Kalel]

Hi Again all, after more 3 months, just got my exams again.
My VL fall from 124 to 53 and still not UD 

I'm happy cause still falling down, but how came it takes so long for a small number to get UD??

Still worried cause my Log calc is falling down:
from [0,62] to [0,45].
And now to [0,37]. (every 3 months)

I'm really used to this regimen and never miss a dose. So it's really frustrating.

Always wording about getting resistant to this regimen...
Trying my best to stay confident.

[mecch]

Did your doctor to say to worry about any of this?
Me, a layman yep, says you are for all purposes undetectable now and you should stop worrying about resistance. Your adherence seems exemplary.
Pat yourself on the back for dealing with HIV and concentrate on living well.

[drewm]

I think you are freaking over nothing. As leatherman pointed out "CD4s and VL counts by themselves don't mean much and are not straight line functions. It's always about the TREND over 3 tests done over a 4-12+ wk period.

Your cd4s are incredible and 500 used to be called "undetectable" just 5 or so yrs ago. Clearly you are NOT becoming resistant because the numbers are still going the right way."

Chill. It's OK. You are on track to be UD 

[leatherman]

Always wording about getting resistant to this regimen...

that's not how resistance works. Resistance means you've had some, but not enough, meds in your system and the HIV evolves to resist that med. When resistance happens your Viral Load goes up, up, up.

speaking of logs and math, did you notice what your VL number really shows? that since your last test, your viral load has been cut in half! That's definitely not resistance but excellent progress!

[Kalel]

Thanks all for your words, I think I needed that clarification. (again lol)
Maybe it's really time to stop worrying and let it be on background. 

You guys are amazing 

[Kalel]

Hey guys,  just came back from my Doctor.

According to him, I not being UD after 13 months can be considered a 'failure of treatment', for many reasons, not necessary my fault..

So he gave me 2 options:

1) Keep Efavirenz for more 1 single month, and I NEED to get UD. If I do, he will do another exam after 3 months, and I have to keep my UD lvl. So he can wait another 6 months.

2) Change Efavirenz by Ritonavir, it need to be kept in a fridge (what s**ks) and might cause yellowing of the white of my eyes sometimes and other stuff.

He said that I would not get resistant to Efavirenz, so he wanted to try this, and if no side effects I could keep it, or I could back to Efavirenz after some months.


I chose option (1) since I'm so used to my meds, and I would hate to be dependent of a fridge to keep my meds all around.

Any idea if this is really a good choice? Or already had enough of Efavirenz and I should move on?

I found totally weird that he is trying to change my meds since Imy VL is 50
(40 is the minimal to show on exams)
Sometimes get that felling like he is not telling me something...

[drewm]

While I appreciate your concern, I think you are too concerned at this point. Your doc said "not being UD after 13 months can be considered a 'failure of treatment' NOT that it IS a failure of treatment. Obviously, getting to UD is a goal you want to pursue but I am glad to you sticking with your meds for now