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Author Topic: Time to failure (Atripla) ?  (Read 12173 times)

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Offline Assurbanipal

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Re: Time to failure (Atripla) ?
« Reply #50 on: March 19, 2009, 11:45:00 AM »
Note, got a nice email back from the AIDSINFOnet folks saying they are looking into it and checking in on why the item was of interest. 
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline Assurbanipal

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Re: Time to failure (Atripla) ?
« Reply #51 on: March 31, 2009, 02:59:45 PM »
Note, got a nice email back from the AIDSINFOnet folks saying they are looking into it and checking in on why the item was of interest. 

After a very pleasant and helpful exchange of emails they dug into some research on the topic that appeared to confirm the hgiher basis and said they are planning to update their fact sheet to reflect a higher normal range sometime in the next month or so.
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline veritas

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Re: Time to failure (Atripla) ?
« Reply #52 on: March 31, 2009, 05:31:38 PM »

Assurbanipal,

Did they say how they arrived at those values? Very disturbing if not backed up by some study.

v

Offline newt

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Re: Time to failure (Atripla) ?
« Reply #53 on: March 31, 2009, 07:03:39 PM »
The PDF perspective reference above  is a conservative crock of old sommat, it includes the years 1996-2001 when treatment was quite sommat and loads of pre-treated monotherapy survivors with loads of nuke resistance will contribute to the low 1.6 years value.

The time to virological failure increases year on year. In the UK in 2005 or 2006 it was 3.5 years for first-line therapy, the main reasons being undetected pre-existing drug resistance and non-adherence because of side effects.

Furthermore the median time to failure only counts the people who's treatment didn't work. Which has been decreasing year on year, for example, in the UK: from around 40% of people in 1996 to 12% of people in 2002. See eg: http://en.scientificcommons.org/37541423 - "Changes over time in risk of initial virological failure of combination antiretroviral therapy: a multicohort analysis, 1996 to 2002" (2006) and other reports.

Provided you have no pre-existing resistance and take your meds on time in the right way (ie food, no food) there is no major reason why you should have virological failure. The one minor reason is drug absorption being poor, but that's not so common.

John - if you have undetected serious NNRTI resistance you will know in 3-6 months. Since your are undetectable after just 3 weeks this is highly unlikely. a viral load under 1,000 at 4 weeks is a good predictor. Your CD4 count and % changes are minor and not important, they are well within the normal variations of a test or two.

 :)

- matt
"The object is to be a well patient, not a good patient"

Offline edfu

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Re: Time to failure (Atripla) ?
« Reply #54 on: April 01, 2009, 03:23:17 AM »
Incidently, my Kaiser labs shows the normal CD4% range as 30 to 60%, and I live right next to San Jose.

My lab (Quest Diagnostics -- in North Carolina), has a reference range of 30%-61% for CD4%.

Quest Diagnostics in Teterboro, New Jersey, has a reference range of 30-61% for CD4% as well. 

If this range is so identical throughout the U.S.--in the West, in the South, and in the East--I don't see any regional differences.  Perhaps the range is different in other countries?   
"No one will ever be free so long as there are pestilences."--Albert Camus, "The Plague"

"Mankind can never be free until the last brick in the last church falls on the head of the last priest."--Voltaire

Offline Assurbanipal

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Re: Time to failure (Atripla) ?
« Reply #55 on: April 01, 2009, 07:29:50 PM »
Quest Diagnostics in Teterboro, New Jersey, has a reference range of 30-61% for CD4% as well. 

If this range is so identical throughout the U.S.--in the West, in the South, and in the East--I don't see any regional differences.  Perhaps the range is different in other countries?  
Assurbanipal,

Did they say how they arrived at those values? Very disturbing if not backed up by some study.

v

Veritas

In addition to the Quest and other US lab ranges, they looked at various papers. 

Edfu
Among the papers (above) were
Bofill et aia with a 95% confidence interval range for British adults and adolescents of 27% to 61% 
Uppal et alia with a 95% confidence interval range for an Indian population of 31% to 50%

No geographic ranges found were as low as 20% to 40%

A
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline John2038

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Re: Time to failure (Atripla) ?
« Reply #56 on: December 27, 2009, 06:33:03 PM »
Weeell, I might have received the second best ever present I could have never dream for a Christmas:

1) The first would have be to be HIV-, but I would have to wait a bit more
2) The second was about my genotype:
After 1 year on Atripla, I am almost undetectable:

CD4 1025 , CD4% 27.10 , VL 21 cp/ml

So indeed, it seems that it was not my genotype (*)

Alelluya !!!! Thanks God ! I feel blessed.

I was just willing to close this story.

(*) Maybe even the one of nobody. Cause the Chief lab responsible of the first genotype told me that at the time they have issued my genotype, they have got a problem with the algorithm:

This problem have lead to the detection of wrong HIV types/subtypes, but should have an impact on the mutations listed said this lab chief.

Well, it seems yes (I am not 100% sure, but I guess if I got the 103, 108, 181 and 215, I will have get a higher VL). Now my body was almost controlling the virus (VL between 300-400 the months starting meds) so I can't be sure.

It has been quite stressing. But seems I am slowly waking up from a nightmare.

I wishes this luck to all people having a bad genotype.

 ::)

 


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