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Author Topic: I have a question on my lateset labs  (Read 1404 times)

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Offline adhoc

  • Member
  • Posts: 28
I have a question on my lateset labs
« on: December 31, 2008, 11:29:53 PM »
Hello everyone
First Happy New Years.

I have just gotten my latest labs back and Im a bit concerned. It seems I have had a blip or treatment failure. I just had my labs drawn two weeks ago (12-09) and was undetectable and the other day (12-26) when I saw my doc she said lets do them again. My T cells went up from 120 to 177 and Viral load went from undetecable to 85000 and log of 4.92. I am currently on Atripla and have not missed a dose and have kept dosage times to within three hours for the entire year I have been on Meds. Any input would be greatly appreciated as Im kinda freaked. I have emailed my Doc but because of the holiday Im sure I wont hear back until Monday, and just wanted to know if this is a normal thing. Has anyone ever heard of lab mix ups? Again any input would be greatly appreciated.
Thanks

alea iacta est

Offline kajnjewel

  • Member
  • Posts: 71
  • Living Life with a Passion!
Re: I have a question on my lateset labs
« Reply #1 on: January 01, 2009, 01:24:12 PM »
Hi Adhoc:

There could be many reasons for the increase - an infection or just a cold can cause the VL to rise as well as building up a resistance to one of the meds on your combo as well.  Try not to freak out (I know that is asking a lot - been there so I do understand) but your Doctor should know what to do to ease your concerns and fears. 

Not sure how long you have been infected or on your current dose other than the year on Atripla but sometimes the virus does weird things to our bodies that causes concerns for all but please know that labs can be wrong thus the doc wanting to do them again.

Main thing is to know that there are many meds on the market and if one of this  meds combo is becoming resistant that there are many more on the market to take its place.

I have been on most of them myself after being infected for 19.5 years and there ARE STILL some my body hasn't become resistant to yet.  So trust me, there is still a lot of hope getting to the root of the problem and finding the best combo for you.

Good luck and try to enjoy the New Year in spite of the labs.
When you were born, you cried and the world rejoiced; live your life in such a manner that when you die, the world will cry and you will rejoice!

Offline aztecan

  • Member
  • Posts: 5,384
  • 29 years positive, 56 years a pain in the butt
Re: I have a question on my lateset labs
« Reply #2 on: January 02, 2009, 09:41:27 AM »
Hey Adhoc,

I understand your consternation with these results, but don't let one set of labs freak you out.

When you talk to your doc, ask whether he/she thinks it is possible the blood sample you provided was handled improperly.

When I had a blip, the doc was able to trace it down to a phlebotomist who didn't handle the blood sample properly and, because of this, the results indicated I had a viral breakthrough or the sudden development of resistance.

A subsequent test showed all was well.

So, as I said, try not to get upset about one set of numbers.

Worst case scenario would be one component of the Atripla you take has failed.

It happens, sometimes without rhyme or reason.

If that is the case, there area still many options open to you. I know the prospect of changing meds isn't one I relish.

But, if that should be necessary, make sure your doc has a resistance test done to see which of the meds you are having issues with.

Then a new regimen can be constructed to fit your lifestyle and needs.

The bottom line here is to avoid panicking or placing too much emphasis on one set of labs.

Hang in there and let us know what your doctor says.

HUGS,

Mark

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

Offline adhoc

  • Member
  • Posts: 28
Re: I have a question on my lateset labs
« Reply #3 on: January 03, 2009, 01:52:18 PM »
Hello Everyone

Thanks Kajnjewel and Mark for your replies.
Since emailing my doctor, the nurse called to let me know that my doc was out of the office and they got the message. They asked me to schedule another appointment. I did one better than that, since I am very proactive about my health. I went to the Dr's office and basically told the RN I want the tests repeated prior to the appointment date as I knew they were going to ask no matter what. So I had another draw done yesterday and I should know in about 6 days or so. Hopefully it was a fluke or something. I will follow up with this post after the results are in.

Thanks
Adhoc

alea iacta est

Offline LordBerners

  • Member
  • Posts: 415
Re: I have a question on my lateset labs
« Reply #4 on: January 03, 2009, 03:03:13 PM »
adhoc, thanks for sharing this situation.  It is similar to my own, though you are further into treatment.  In my case I am only 4.5 months into treatment with Truvada and Sustiva, so the same as your Atripla.  At six weeks I was down from 100,000 VL to 2,700, and CD4 up from about 180 something and about 15% to about 450 and 28%!  Alas, three months after that I'm back up to a 10,000+ VL and though they did not give me my CD4s, etc., the doctor and I agreed by email that resistance is extremely likely.

Of course typically resistance in our combo first sets in about efavirenz (Sustiva), but the sad part is that if you keep taking it with efavirenz resistance one inevitably also gets resistance to one or both of the components of Truvada (emtricitabine and tenofovir).

I'm curious how you access health care - it seems to me that those who have good access to health care, such as Europeans, can feel fairly confident that a replacement combo can be found for them and will be provided.  For those of us without access to health care (I'm american), the idea of shifting to second line treatments which are even more expensive is daunting. 
Please, just call me Berners.. or Baron.

Offline adhoc

  • Member
  • Posts: 28
Re: I have a question on my latest labs
« Reply #5 on: January 10, 2009, 12:38:25 PM »
Hello Everyone

I have gotten my labs back a couple of days ago. It is with great relief that what Mark had suggested was the culprit. "Lab Error" .  My last VL was undetectable and my CD4s are still in the 13% range.
It is a load off my mind to know that the meds are still working as they should.   :)

Lord Berners, In a discussion with my Doc I had asked how if what happened to me was possibly resistance. I was told that being this far into treatment and doing so well,  it was highly unlikely that this was resistance. If I had adherence problems then yes. Most of the time, as I was told that most issues manifest within the first few months of treatment. Even with the first resistance test at time of diagnosis coming back unresistant, resistance issues could still arise after three months or so. I'm sure this more or less applied to me directly. I wish I had more to share on this but I am still learning alot myself.
BTW did I read that you started meds then stopped a couple of times a while back? If so this might have something to do with the resistance as the virus has to be completely suppressed to prevent resistance. If not then please disregard I might be thinking of another post I read some time ago.

As far as access to health care, I have very good access. I have health insurance that I started out of pocket some time ago.  I have a good feeling that as far as access to health care is concerned in the US is going to be changing soon with the new administration or at least I hope it does. If what I have read in my state is true and I comprehended correctly that coverage cannot be denied if you disclose preexisting conditions at time of applying. You may not have the best rates especially paying out of pocket. I do know when insured you have to have meds that fall under the companies formulary. Drugs not under this are considered new, experimental or requiring approval. I know that my insurance company approves the use of just about all of the drugs for HIV. Im not sure of the cost of second line treatments but the thought of paying up to 50.00 a dose of Atripla scares me  :o. Especially since a generic is not coming out till about 2019 or so. So I consider myself very lucky.

Adhoc
alea iacta est

Offline LordBerners

  • Member
  • Posts: 415
Re: I have a question on my latest labs
« Reply #6 on: January 10, 2009, 02:46:31 PM »
Lord Berners,
BTW did I read that you started meds then stopped a couple of times a while back? If so this might have something to do with the resistance as the virus has to be completely suppressed to prevent resistance. If not then please disregard I might be thinking of another post I read some time ago.

Adhoc I'm so glad to hear that your results turned out to be a lab error.  As for me yes I stopped twice previously, so that could have caused resistance.. though now I'm kind of wondering at the doctors' decision to take me off the meds so quickly.  We'll see.
Please, just call me Berners.. or Baron.

Offline red_Dragon888

  • Member
  • Posts: 2,811
  • Love and Be Love in Return
Re: I have a question on my lateset labs
« Reply #7 on: January 10, 2009, 10:25:55 PM »
i have not heard of labs mix ups but it sound possible to me they made a mistake with your labs.
http://www.youtube.com/watch?feature=player_embedded&v=I3ba3lnFHik

“Neither look forward where there is doubt nor backward where there is regret. Look inward and ask not if there is anything o

Offline adhoc

  • Member
  • Posts: 28
Re: I have a question on my lateset labs
« Reply #8 on: January 14, 2009, 03:35:12 PM »
Hello Everyone,
One more thing to add to this post. I finally got the results from the Resistance test and again it confirmed everything. Genotyping not possible to insufficient viral load.  :)
Adhoc
alea iacta est

 


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