Quantcast

Subscribe to:
POZ magazine
E-newsletters
Join POZ: Facebook MySpace Twitter Pinterest
Tumblr Google+ Flickr MySpace
POZ Personals
Sign In / Join
Username:
Password:
Welcome, Guest. Please login or register.
September 21, 2014, 06:12:11 AM

Login with username, password and session length


Members
  • Total Members: 23510
  • Latest: yuanti
Stats
  • Total Posts: 639629
  • Total Topics: 48549
  • Online Today: 210
  • Online Ever: 585
  • (January 07, 2014, 02:31:47 PM)
Users Online
Users: 2
Guests: 125
Total: 127

Welcome


Welcome to the POZ/AIDSmeds Community Forums, a round-the-clock discussion area for people with HIV/AIDS, their friends/family/caregivers, and others concerned about HIV/AIDS.  Click on the links below to browse our various forums; scroll down for a glance at the most recent posts; or join in the conversation yourself by registering on the left side of this page.

Privacy Warning:  Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If you are HIV positive and disclose this in our forums, then it is almost the same thing as telling the whole world (or at least the World Wide Web). If this concerns you, then do not use a username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.

  • The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own physician.

  • All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.

  • Forums members must behave at all times with respect and honesty. Posting guidelines, including time-out and banning policies, have been established by the moderators of these forums. Click here for “Am I Infected?” posting guidelines. Click here for posting guidelines pertaining to all other POZ/AIDSmeds community forums.

  • We ask all forums members to provide references for health/medical/scientific information they provide, when it is not a personal experience being discussed. Please provide hyperlinks with full URLs or full citations of published works not available via the Internet. Additionally, all forums members must post information which are true and correct to their knowledge.

  • Product advertisement—including links; banners; editorial content; and clinical trial, study or survey participation—is strictly prohibited by forums members unless permission has been secured from POZ.

To change forums navigation language settings, click here (members only), Register now

Para cambiar sus preferencias de los foros en español, haz clic aquí (sólo miembros), Regístrate ahora

Finished Reading This? You can collapse this or any other box on this page by clicking the symbol in each box.

Author Topic: hiv and hpv your thoughts on getting an early start with meds  (Read 2465 times)

0 Members and 1 Guest are viewing this topic.

Offline livingpos

  • Member
  • Posts: 30
hi all,

my doc and I are discussing the possibility of starting meds early. I have been pos for 1.5 years. From sero conversion CD4 450 and VL in the millions the numbers bounced around a bit in the next few tests. CD4 650 VL 1800, CD4 550 VL 17000, CD4 450 VL 65000, CD4 700 VL 16000. Percentage has hovered around 32-35. It seems that things have settled down since the last numbers were looking good. I'll have the next test in 2 weeks.

The problem is the HPV. It went apeshit! There were so many warts in the perianal area that I had to have them removed under general anaesthetic. Twice! And they are back again worse than before. Doc thinks that my body might be doing ok with the hiv infection but is struggling to manage the hpv on top of it. He thinks that if meds can take care of the hiv my body might be able to spare some energy to devote to the hpv. No garantees but sounds logical.

I also have the herpes simplex that causes cold sores on the mouth. I haven;t had one since being pos but I started getting one yesterday.

I have nothing against early treatment per se. I have read all the benefits. But I also would like to stay off the meds as long as possible for all the usual reasons. It seems a pity to start with a CD4 of 700 and a percentage in the normal range. BUT i really can't take these anal wart outbursts anymore! I will have the anal pap smear and have them removed again in 2 weeks.

Any thoughts on early starts with multiple infections? I trust my doc implicitly. He has been working with hiv for 20 years but I also value the lessons of experience.

thanks
Jonathan

Offline aztecan

  • Member
  • Posts: 5,398
  • 29 years positive, 57 years a pain in the butt
Re: hiv and hpv your thoughts on getting an early start with meds
« Reply #1 on: June 03, 2007, 11:43:57 PM »
Wow Jonathan,

This is a toughy. I really don't know a lot about HPV. Are there any other options to eradicate this problem aside from starting ARV therapy?

I am an advocate of starting ARV therapy earlier rather than later, but this is much earlier.

But, if the only option is removal, as you have had in the past, what your doctor said regarding your body's ability to fight off the HPV ourbreaks makes sense.

I have known others who suffered similar outbreaks and who improved after beginning ARV therapy. But, all of those whom I have known had much lower CD4s and higher viral loads.

You said you would like to postpone starting meds at this point. I don't blame you there. Your counts are good.

Starting now might help the HPV problem or might not, as your doc said.

If it were me, I think I would start meds simply because of the pain and anguish you are suffering because of the HPV.

Years ago, my doc gave me a somewhat similar option. My CD4s were still in the 400s and viral load of about 50,000.

She said she had no idea what the long-term side effects would be or how long I would be able to tolerate the meds.

I lasted 11 years on that regimen, which is pretty good.

Today, there are many new meds and the side effects are better known on many of them.

If I were given the chance to end the HPV problem with my backside, as you have been, I think I would give it some hard, serious thought, but would probably opt to try it.

I would rather take a chance, even without a certain outcome, rather than do nothing and let things continue as they are now.

Just my 2Ę worth. Let me know what you decide.

HUGS,

Mark

"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline Miss Philicia

  • Member
  • Posts: 24,107
  • celebrity poster, faker & poser
Re: hiv and hpv your thoughts on getting an early start with meds
« Reply #2 on: June 04, 2007, 12:47:59 AM »
Well, I for one had feisty, feisty anal warts and I was on HIV treatment, and had been so for five years by then.  My numbers were probably up in the mid-400 cd4's at the time.  Not sure what my VL was as that test wasn't available in that year.  Minor were also eventually surgically removed after many unsuccessful attempt by less invasive methods.  Thankfully they never returned for me after the surgery.  Sorry to hear about your current situation, as I *totally* know what it's like.  That was a wretched year for me.

Anyway, exactly how high does he state your numbers need to be for your body to deal with getting rid of the AW's?  I'd be less skeptical of his claims if you numbers were really low, but they aren't.  It's just I've never heard of this before, so I'll be interested if anyone else has.  To be honest it's rather typical of them to return, and the CDC recommends checkups every 3-6 months for 1.5 years for this very reason, and this is exclusive of HIV status.

I assume you're having your PCP taking care of this right now?  Maybe you'd feel better seeing a butt doctor specialist (forget what they're called), preferably one that treats a sizable amount of gay people and thus will be quite familiar with the HIV angle.
"Iíve slept with enough men to know that Iím not gay"

Offline J.R.E.

  • Member
  • Posts: 7,162
  • Joined Dec-2003 Living positive, since 1985.
Re: hiv and hpv your thoughts on getting an early start with meds
« Reply #3 on: June 04, 2007, 08:52:14 AM »
Wow Jonathan,

This is a toughy. I really don't know a lot about HPV. Are there any other options to eradicate this problem aside from starting ARV therapy?



I must have had the HPV for some time, prior to starting on meds, but it was not visible. For me, the problem started shortly after the  antiretrovirals were started. I wonder if that was immune reconstitution syndrome??

Aldara Cream didn't do anything, The podofilox solution made them all go away, except every once in a while, I have to reapply it, so I have an endless refill for the podofilox solution, for the time being.



Ray
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 8/2514,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

Offline J.R.E.

  • Member
  • Posts: 7,162
  • Joined Dec-2003 Living positive, since 1985.
Re: hiv and hpv your thoughts on getting an early start with meds
« Reply #4 on: June 04, 2007, 09:01:43 AM »


Also just a reminder, you don't have to be HIV positive to get HPV. It's highly contagious, through contact !


Ray
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 8/2514,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

Offline livingpos

  • Member
  • Posts: 30
Re: hiv and hpv your thoughts on getting an early start with meds
« Reply #5 on: June 04, 2007, 06:36:58 PM »
Mark, philly and Ray

thank you for your replies, much appreciated. You're right you don't have to pos to have hpv and warts, but what a daily reminder it has been, as if the hiv wasn;t enough to deal with. And as for them being contagious i have had to kiss any sexual contact goodbye!

Doc isn;t making any promises, he's much to honest for that. Its just a guess at a strategy that might work but no research or evidence to support it. He went back and did extensive research on who's trying what therapies but it seems its quite limited. Aldara produces results while i am using it but as soon as i stop its back to square one. I will discuss the podofilox with the doc.

Philly, Ray your experience of warts even on hiv meds is helpful to me, thanks. If my test results are still as good, I think I will forego starting meds and opt for the surgery and one more try. Doc will send me to a surgical proctologist that is experienced with this. Lets see what he says. If I'm gonna go through the pain again, he better stay down there till he gets em all!  ;)

Mark ur 2cents is worth its weight in gold, your replies always have such optimistic candor.

all the best to you and thanks
Jonathan

Offline whizzer

  • Member
  • Posts: 363
Re: hiv and hpv your thoughts on getting an early start with meds
« Reply #6 on: June 04, 2007, 07:53:45 PM »
Jonathon,

There IS a documented relationship between HIV viral load and HPV.  It has been noted that VL>10,000 results in an increase in HPV and abnormal pap smears.  It is thought that HIV somehow effects HPV expression, either directly  by HIV itself or by local cytokine production.   

Some clinicians have noted a significant difference in viral load (but interestingly, NOT CD4) between HIV positive patients with warts who experienced a relapse in HPV infection, and those who did not relapse.  It is surmised that HAART would have an indirect benefit on HPV lesions.

Here's a Medscape article.  You have to join to read it, but it is free:

http://www.medscape.com/viewarticle/410246_3

Good luck with your treatment.  I hope you get a favorable outcome.

-Whiz

Offline J.R.E.

  • Member
  • Posts: 7,162
  • Joined Dec-2003 Living positive, since 1985.
Re: hiv and hpv your thoughts on getting an early start with meds
« Reply #7 on: June 04, 2007, 08:05:57 PM »
Here's a Medscape article.  You have to join to read it, but it is free:

http://www.medscape.com/viewarticle/410246_3

Good luck with your treatment.  I hope you get a favorable outcome.

-Whiz


Whiz,

Thanks for that article. Very informative. I thought I had read most articles, but I missed this one.



Thanks---Ray
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 8/2514,  t-cells are at 402, Viral load <40

 Current % is at 11%

  
 62 years young.

Offline Miss Philicia

  • Member
  • Posts: 24,107
  • celebrity poster, faker & poser
Re: hiv and hpv your thoughts on getting an early start with meds
« Reply #8 on: June 04, 2007, 08:06:10 PM »
That's very interesting whizzer.  Thanks.
"Iíve slept with enough men to know that Iím not gay"

Offline livingpos

  • Member
  • Posts: 30
Re: hiv and hpv your thoughts on getting an early start with meds
« Reply #9 on: June 05, 2007, 08:29:44 AM »
whizzer... thanks... and to all others yet again prood of the benefits of shared wisdom and resources... love to all
Jonathan

 


Terms of Membership for these forums
 

© 2014 Smart + Strong. All Rights Reserved.   terms of use and your privacy
Smart + Strong® is a registered trademark of CDM Publishing, LLC.