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Safe To Stop Septrin Now?

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Londonguy:
So I got my latest labs today, and my last few results now look like this

CD4 200 VL 24,000
CD4 211 VL 27,000
CD4 188 VL 37,000
CD4 220 VL 21,000

So essentially I'm staying pretty stable.  They still haven't put me on meds yet but I guess it's a matter of time.  Thing is, when I heard my CD4 was over 200, my first thought was that I could stop taking the Septrin, but they still want me to take it.  I really don't want to because it upsets my stomach.  I told them it was causing me quite acute pain, but they said they didn't think it was related to the Septrin because I had already taken it for a few weeks with no real problem apart from feeling a bit sick and a decreased appetite.  Hmmm.

But I hear a lot of people on here talking about stopping the Septrin when they get over 200 CD4.  Would I be silly if I stopped taking it against their advice?

Cliff:
Have you asked why they have decided against giving you meds?  Are you recently infected, and they expect your tcells to rise?  If not, I would seriously consider going on treatment as your tcells are roughly in the 200 range where treatment is advised.

Tim Horn:
Dear Londonguy:

This is definitely a conversation you should be having with your GP.  As a rule of thumb, PCP prophylaxis can be stopped if the CD4+ cell count remains above 200 for three to six months while on antiretroviral therapy.  However, your situation raises a few important considerations:

1) Your CD4+ cell count has been on the border of 200 for the last four blood tests.  In fact, your second-to-last test yielded a CD4+ cell count of 188.

2) You're not on antiretroviral medication.  When the viral load is detectable (read: untreated) -- even "low" detectable like yours -- it's much harder to predict what your CD4+ cell count will do in the months to come.  

Like I said, it's best that you talk to your GP about this.  Your situation doesn't really allow for a clear-cut answer -- and poses a few important concerns -- it really would be foolish to stop against your GP's advice. 

Tim Horn

Londonguy:

--- Quote from: Cliff on June 29, 2006, 08:07:57 AM ---Have you asked why they have decided against giving you meds?  Are you recently infected, and they expect your tcells to rise?  If not, I would seriously consider going on treatment as your tcells are roughly in the 200 range where treatment is advised.

--- End quote ---

Well it's because they plummeted from around 420 to 200 when I had secondary stage syphilis.  They kept waiting and waiting to see it recover but it doesn't seem like it's going to, at least not to the point where I was at prior to the syphilis.  But they still seem reluctant to start me on treatment, they certainly haven't seemed concerned about my results at all.  It's been 3 months since I finished the treatment for syphilis, which is now down from 1:128 to 1:16.

I guess I should have made it clearer that those results are over a four month period, from February, when I was diagnosed with syphilis, to last week, so it isn't like I've been like this for a year or something.  I dunno what to think really, they don't seem to be in any great rush to do anything with me. I suppose I should still keep taking the Septrin considering my VL  :(

Cliff:
oh ok.  I erroneously thought that were your results for each 3-month check up.  Though you should still have a talk with your doctor regarding how long they think you should keep on this wait and see approach path.  It seems reasonable, but I personally wouldn't want to go too long with tcells in that range (especially given you are also fighting Syphilis)...but it's really your call and whether or not you are ready for treatment.  No rush.

Good luck and stay on the Septrin till your doctors say otherwise!

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