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Author Topic: DOCTOR SUGGEST: ' NO VIRAL LOAD TEST' REQ.  (Read 3161 times)

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Offline indianhiv

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« on: May 09, 2008, 10:56:55 PM »
I an a Indian. My  Doctor suggested Atripla along with two other ART drug. The same were prescribed without any resistance test. The onlt test he relied  uponwas the CD4 test. There are no facilities with him to test Viral load. Incidentally he is the only HIV doctor is our city. After going through this forum its seems that VL is one of the most important parameter and also necessary. He suggested that Indians are generally not resistant to any anti HIV drug and hence no resistance test. I find this very astonishing. I thank the forum to make me a intelectual as far as HIV and its treatment is concern.

Offline Dragonette

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« Reply #1 on: May 10, 2008, 12:40:48 AM »
Hi Indian,

I'm sorry you don't have access to those tests... I also never had a resistance test before I started meds because  it was not available  at the time where I was diagnosed. Later when it became available (after 1.5 years on meds) they did it on the frozen blood and there was no mutation (resistance) originally.

Even though the ideal is to do a resistence test, in reality a lot of places don't do it or have only just started to. With the VL, that's maybe more disturbing, but I suppose they can go on CD4s. In my case their desicion to put me on meds was based on CD4s alone, as they were low,and the VL only came in days later.

What I'm trying to say is, though the way things are done in that clinic might not be 100% ideal, you can still get very effective treatment. Hopefully there will be a way to do a VL in the future, to determine that you're undetectable. It's basically a faster way of knowing everything's OK because the CD4s take longer to rise than the VL to drop. But I think that any rise in CD4 will indicate the drugs working and the VL in fact decreasing.

Good luck,
"If you keep one foot in yesterday, and one in tomorrow, you piss all over today". Betty Tacy

Offline keyite

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« Reply #2 on: May 10, 2008, 05:42:42 AM »
I agree with Dragonette, hopefully you will be able to get the VL done too at some point. When not on meds the CD4 test is the most important but when on meds it is actually the VL that is the most important (because the objective of HAART is to reach an undetectable VL). The CD4 test will indicate if things are going in the right direction but it will not tell you if you are undetectable.

I was surprised to hear you are on Atripla along with two other HAART drugs. Atripla actually combines three different HAART drugs into one pill, so that would make it five drugs in total. Normally three is sufficient so this seems excessive for someone with no established history of resistance?

Best of luck.

Offline next2u

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« Reply #3 on: May 10, 2008, 10:37:38 PM »

my dr prefers cd4 & cd4 percentage tests. i have to remind him each time to do the viral load test. he tells me that they are the only two i need at this time and he can gauge hiv progression using these two variables. my id doc has been in the game for over 20 years and is well respected in our lil community (not necessarily the poz community, but other drs speak highly of him).
midapr07 - seroconversion
sept07 - tested poz
oct07 cd4 1013; vl 13,900; cd4% 41
feb08 cd4  694;  vl 16,160; cd4% 50.1
may08 cd4 546; vl 91,480; cd4% 32
aug08 cd4 576; vl 48,190; cd4% 40.7
dec08 cd4 559; vl 63,020; cd4% 29.4
feb09 cd4 464; vl 11,000; cd4% 26
may09 cd4 544; vl 29,710; cd4% 27.2
oct09 cd4 ...; vl 23,350; cd4% 31.6
mar10 cd4 408; vl 59,050; cd4% 31.4
aug10 cd4 328; vl 80,000; cd4% 19.3 STARTED ATRIPLA
oct10 cd4 423; vl 410 ;); cd4% 30.2
jun11 cd4 439; vl <20 ;); cd4% 33.8 <-Undetectable!
mar12 cd4 695; vl ud; cd4% 38.6
jan13 cd4 738; vl ud; cd4% 36.8
aug13 cd4 930; vl ud; cd4% 44.3
jan14 cd4 813; vl ud; cd4% 42.8
may14 cd4 783; vl *; cd4%43.5
sept14 cd4 990; vl ud; cd4% *
jun15 cd4 1152; vl ud; cd4% *
oct15 cd4 583; vl 146; cd4% 42
mar16 cd4 860

Offline RapidRod

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« Reply #4 on: May 11, 2008, 12:53:44 PM »
next2u, then can you explain how your doctor know if the medication you are on is working or not? A viral load test would tell you if your medication is working or not a lot faster than a CD4 test. 

Offline Miss Philicia

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« Reply #5 on: May 11, 2008, 01:12:31 PM »
I have a viral load test done every time I have blood work taken.
"Iíve slept with enough men to know that Iím not gay"

Offline Ann

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« Reply #6 on: May 11, 2008, 01:35:20 PM »
Rod, Next2U isn't on meds yet and that's why his doctor says he doesn't need the VL test at this time. It's perfectly reasonable. I'm not on meds yet either and they don't always do a VL on me either, for the same reason. It's not all that necessary.
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Offline indianhiv

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« Reply #7 on: May 11, 2008, 11:16:12 PM »
Other than Atripla, he has prescribed a limivudine + Zidovudine comi. Two tab of this combi during day time and an  Atripla at night time. He also suggested that a sudden drop in  Hamoglobin levels would compel him to discontinue Zido. The next thing that someone asked was how does the Doctor know the meds are working? Well a CD4 test is done after 4 months of starting meds. This doctor has a 5 yrs expericence and is the only on dr. available in a radius of 500 Kms. Medical facilites are not as good here as in western countries. No VL test no resistance test. After going through this forum I feel very secured and safe. I get all the information, right advice and mental support. 

Offline BooBoo

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« Reply #8 on: May 12, 2008, 06:59:24 PM »
I really don't know why your doctor has prescribed that combination of meds.....I my opinion it seems like too much.  If you doctor is working on the assumption that you have no resistance to any of the meds then the Atripla should be all that you need.  Plus your doctor is giving you a double dose of basically the same drug.  Atripla is made up of three drugs.....efavirenz + tenofovir + emtricitabine.  And limivudine and emtricitabine are very similar and it is not believed that combining these two anti-HIV drugs will make a regimen any more effective against the virus......you should not be on both of those drugs at the same time.

If you have no resistance to any of the meds then it is my understanding that Atripla is all that you would need to be taking and you dont need to be taking limivudine and zidovudine.  I think you should talk to your doctor and have him explain to you why he has prescribed this combo......it seems a bit strange to me.


p.s.  Are you sure that your doctor prescribed ATRIPLA and not just SUSTIVA??  If he prescribed Sustiva + limivudine + Zidovudine then the combo makes perfect sense.
« Last Edit: May 12, 2008, 07:09:24 PM by BooBoo »

Offline indianhiv

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« Reply #9 on: May 12, 2008, 11:51:00 PM »
U are right BooBoo. It is Sustiva and not Atripla. Infact in India we have nether Sustiva or Atripla but tabs having Sustiva as content. You would be suprised to learn that whole month of medicine in India cost Rs. 2300 i.e. 57.5 US$. Now I think that is the cheapest. I know a lot of people who carry drugs with them to US or other countries for cost cutting. At least for that part we are the luckiest. I'v also heard that CIPLA one of the compnay making anti HIV drug supplies to the UN also. As it is the cheapest anybody can get. In any case how do you find the combo. Sustiva at night along with one limo and zidu combo in the morning and one at night. We have the drug but not the right Doctors in our area.

Offline RapidRod

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« Reply #10 on: May 15, 2008, 08:06:23 AM »
Ann, they could still see how the virus is or is not progressing by doing a viral load test when they go in for labs. I had a viral load test done every three months for 21 years before ever going on meds. I guess it all depends on how proactive your ID doctor is.   


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