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Author Topic: what is the method of attack nowadays? hit em hard, hit em now? or wait?  (Read 1840 times)

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Offline schnitzer

  • Member
  • Posts: 43
for someone who is newly diagnosed, what is the method of treatment nowadays?

i remember when i first got it, the doc was like hit em hard hit em now... but then they took me off of it..

few years later when my numbers are starting to drop, i'm back on it now. .

what are doctors doing nowadays?

Offline Miss Philicia

  • Member
  • Posts: 23,888
  • celebrity poster, faker & poser
schnitzer, you may be interested in reading this recent Poz.com article about some new found data from a Dutch study showing that early treatment may have advantages for more easily achieving a higher CD4 count over the long term.

Now that the newer treatments are seemingly less toxic than what was available even just five years ago I'm sensing that there may be a change in current  U.S. Department of Health and Human Services recommendations.  Of course, federal government standards may lag behind developments so you're going to have to make a decision to start earlier with your doctor.

Otherwise please consult the AIDSmeds - Starting Treatment section.

(clicking on the parts of my post that are underlined will take you to the relevant web links)
"Iíve slept with enough men to know that Iím not gay"

Offline Tempeboy

  • Member
  • Posts: 356
  • Like St Francis of Assisi I am wedded to Poverty
Local guidelines (Australian) suggest starting when:

i/  CD4 count is approx 350 (but not less) and/or
ii/  viral load is less than or equal to 35 000 and/or
iii/  presence of HIV related illness and/or
iv/  when you are ready

These suggestions are based on the notion that there are good clinical indicators for starting treatment - and these reasons change over time in relation to new research.  The biggest predictor of treatment success is the readiness of the individual.  This correlates strongly with adherence.  Readiness is different from willingness and/or eagerness, the notion of readiness speaks to the individuals ability to undertake to engage with a treatment combination over time.

I hope this makes sense.
Roughly roundabout somewhere in the eighteenth or nineteenth century, Sodomite begat Homosexual out of moral, medical and legal models, bequeathing him Identity, who inbred with Nuclear Family and Industrialism to spawn Homophobia.

Dean Kiley

Offline Miss Philicia

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  • Posts: 23,888
  • celebrity poster, faker & poser
I'm confused.  One of your old posts says you started meds in November 2006.
"Iíve slept with enough men to know that Iím not gay"

Offline Miss Philicia

  • Member
  • Posts: 23,888
  • celebrity poster, faker & poser
... and another says you took Crixivan 5/6 years ago when you were diagnosed at age 16

Now that I'm rereading the odd phrasing in your first post I see you don't totally say that this is about yourself, but then again it's vague.
« Last Edit: June 10, 2007, 10:57:12 PM by philly267 »
"Iíve slept with enough men to know that Iím not gay"

Offline schnitzer

  • Member
  • Posts: 43
hey philly, i'm researching for a friend.. he recently diagnosed and doesn't have health insurance..  so i'm wondering if he should hold off on treatment or not??   he lives in SFO, is it still possible to get health insurance? otherwise he'll have to buy cheap meds from thailand.

when i was first diag, i was put on meds right away.. but then got taken off because they were worried about the long term effects.. i guess they must have a different approach now.

Offline megasept

  • Member
  • Posts: 478
  • Steven here...

A: Wait.

Let's assume that the report Philly shares with us is correct. How long does the window stay open? What's the likely error rate in predicting date of seroconversion? I can imagine that estimates of weeks, not months, would make a difference in this kind of scenario. It's a big issue because once on meds this kind of patient probably ought to stay on the same meds indefinitely, unless there's some failure.

Secondly, the hit-it-early-hit-it-hard as standard treatment is only advocated by a small minority today. Like Schnitzer, I was also taken of meds, and not because of complications (yet), just a new paradigm----diagnose, monitor closely, and treat only when needed (VL> 100k and/or CD4 <350 or 300, and/or certain OIs)

So, I don't think the pendulum has shifted all the way back, Schnitzer.

 8)  -megasept

Offline aztecan

  • Member
  • Posts: 5,384
  • 29 years positive, 56 years a pain in the butt
Personally, I wouldn't let my CD4s drop below 350, regardless of the viral load. My T cells stayed at 600-900 for more than a decade before I started meds.

When they dropped, they dropped like a stone to 430 (or was it 440) its hard to remember.

Anyway, my viral load never exceeded 50,000, but the CD4s were definitely dropping. So, I think monitoring yourself closely and then, when the time comes, deciding how best to attack the virus while keeping as much as your historic immune system intact. Of course, I mean doing this with your doctor.

It is a kind of balancing act. No, you really don't what hyperlipidemia. But, on the other hand, you certainly don't want PCP (or whatever it is they are calling it these days), PML or any of the other nasty opportunistic infections that can occur.

By the way, the graph your labs tool here is great because it allows you to see where you have been and what patterns are developing. You can also put in all of the labs you want, so you can track CD4s, Viral load, percentage, cholesterol, whatever.

Good luck and hand in there.

HUGS,

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

 


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