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Author Topic: Poll - For First Line HAART Folks - Would you have Started Treatment Sooner?  (Read 5760 times)

0 Members and 1 Guest are viewing this topic.

Offline risred1

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As it stand today, after only a couple weeks of treatment, and even before my first blood test, that based upon how I feel, I should have started sooner, perhaps 6 to 9 months ago, when I started to feel bad, even though my numbers were ok at that time.

I definitely should have started when my doc was advising me too. But I waited 4 months only to find my cd4 dropped further. (i just knew it, based upon how I was feeling in general.)

But what is your thought?

For those on their Initial Combo. Based upon your experience alone. If you could, would you have started treatment earlier?

LTS who had to endure the early medications, please, provide your perspective as well. While this is largely about current treatment today. We can't forget what treatment was like in the past and the price that was and is still being paid. But please just provide perspective if you' d like to comment. (well we all know I can't enforce anything, But this is a serious question we face. When to start in today's world. If this sounds crass, I apologize.)
risred1 - hiv +
02/07 CD4 404 - 27% - VL 15k
10/07 CD4 484 - 31% - VL 45k
05/08 CD4 414 - 26% - VL 70k
01/09 CD4 365 - 23% - VL 65k
05/09 CD4 291 - 23% - VL 115k - Started Meds - Reyataz/Truvada
06/09 CD4 394 - ?% - VL 1200 - Boosted Reyataz with Norvir and Truvada
07/09 CD4 441 - ?% - VL 118 - Boosted Reyataz with Norvir and Truvada
09/09 CD4 375 - ?% - VL Undetectable - Boosted Reyataz with Norvir and Truvada
12/09 CD4 595 - ?% - VL Undetectable - VIT D 34 - Reyataz/Truvada/Norvir

Offline SoSadTooBad

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oh my gosh, I would have started earlier.  I was diagnosed with a CD4 count of 78.  Bad idea.

I was scared to get tested, even though I strongly suspected that I was positive.  Bad idea.

When I finally started, I was on Combivir and Sustiva.  Not a bad combo - the Combivir made me a little nauseous, but overall I did fine.  Now on Atripla, which is a walk in the park.  Undetectible and a CD4 of about 450 three years later.

I am humbled by the LTS who soldiered through many difficult regimens, and even more humbled by those who never even had that option. 

Offline a2z

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But what is your thought?


Nope, I think I started at just the right time.
Dates are blood draw dates:
09/21/09: CD 898 27.0% VL 120 - back on track, same meds.High level enzymes, but less so
06/15/09: CD4 478 21.8% VL 1150 - high liver enzymes... looks like I may not be resistant
05/22/09: Fixed insurance, resumed medicine
04/17/09: Ran out of medicine, could not resolve insurance problems
04/01/09: CD4 773 28% VL 120 - high liver enzymes
12/01/08: CD4 514 23% VL 630
10/17/08 started Reyataz, Norvir and Truvada. -- possibly minor neuropathy, but otherwise okay.
9/10/08: CD4 345 17%, VL > 78K
8/18/08: CD4 312 18%, VL > 60K (considering meds)
12/19/07: CD4 550 28% VL > 100K (no meds yet)
Diagnosed 10/23/07

Offline BM

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I had no idea I was positive. Had I been diagnosed earlier, I would almost certainly have started meds when my doctor suggested it.
« Last Edit: June 07, 2009, 10:10:45 AM by BM »

Offline bufguy

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judging by these replys, the response should be; "should I have been tested earlier"
So many people don't know, therefore their health deteriorates and just as bad they may unknowingly infect others.

Get tested!
5/29/08 confirmed HIV+
6/23/08 Vl 47500  CD4 511/29% CD8 .60
start atripla
8/1/08 Vl 130  CD4 667/31% CD8 .70
9/18/08 Vl un  CD4 not tested
12/19/08 Vl un CD4 723/32% CD8 .80
4/3/09 Vl un CD4 615/36% CD8  .98
8/7/09 vl un CD4 689/35% CD8 .9
12/11/09 vl un CD4 712/38% CD8 .89
4/9/10 vl un CD4 796/39% CD8 1.0
8/20/10 vl un CD4 787/38% CD8 1.0
4/6/10 vl un CD4 865/35% CD8 .9
8/16/10 vl un CD4 924/37% CD8 1.0
12/23/10 vl un CD4 1006/35% CD8 .9
5/2/10 vl un CD4 1040/39% CD8 .9
8/7/13 vl un CD4 840/39% CD8 .9

Offline antibody

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  • "every man thinks his burden is the heaviest"
if i'd known boosted reyataz and truvada was so easy i would have started on diagnosis. I started about 2 years after diagnosis and had a cd4 count of about 485. My doctor told me the side effects are more frequent when you start at  too low a count and I knew the HIV was taking it's toll on my body. I didn't want to wait anymore to do something to fight the virus.
I must say that I wish I would have started with the truvada reyataz norvir but I actually started treatment with Acripla (atripla) and had to change because the CNS issues never went away. the boosted reyataz has been a walk in the park compared to Acripla
I guess i should add my viral count was only 8,000 when I began treatment. and A cd4 of 485 so technically I did start treatment early or earlier than the recommendation.
« Last Edit: June 07, 2009, 09:36:42 PM by antibody »
Timbuk      <50/ 794  CD4 10/06 
                 <50/ 1096 CD4 3/07
                 <40/ 1854 CD4 4/09

Started Atripla  7/14/06
Switched to boosted Reyataz Truvada 3/28/07

*Ask me about Medical Marijuana and how it can help you!*

Offline mecch

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  • red pill? or blue pill?
I was diagnosed even before my HIV seroconversion - that is, before I was HIV+ but with virus detected by other means.

If we had known - doctors and I - that I was a fast progressor, yes, of course, it would have been better to start immediately.  But who knew...  Still, i think I went a month or two too long, cause I really slowed down after a few months positive with viral loads in the millions. 

There is one doctor in Switzerland who routinely treats at seroconversion, if it is caught at that time.  It's from the theory a few years ago that treatment at seroconversion is the best. He was NOT my specialist.

I wonder how many HIV specialists still recommend treatment at seroconversion.

I bet eventually we come back to that method as best practice.
ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

Offline WillyWump

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Definatley earlier, Atrpila is amazing and has changed the way I feel (energy, etc...) to how I felt pre-HIV.

POZ since '08

Last Labs-
6/3/14 CD4- 736, UD 34%
6/25/13 CD4- 1036, UD,
2/4/13, CD4 - 489, UD, 28%

Current Meds: Prezista/Epzicom/ Norvir
.

Offline HereIAm

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YES!  I would have started the first day knowing what I know now and especially judging how I feel on meds.
Tested Positive 10 Sept 2008.
24 Sept 2008:  CD 4: 23;   1%;  VL: 770,709
1st Oct 2008:  Started Atripla
4 Dec 2008:  CD 4: 145; 8%, VL: 209
1 March 2009:  CD 4: 91; 8%, VL: 49 (undet)
1 June 2009:  CD 4: 164; 11%, VL: 61
8 July 2011:  CD 4: 286; 17%, VL Undet
28 Oct 2011: CD 4: 346; 21%, VL Undet
2 Mar 2012: CD 4: 316; 20%, VL 6800 (probably an error)
12 Apr 2012: CD 4: 333; 21%, VL Undet

Offline bmancanfly

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earlier, much earlier.
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline MOONLIGHT1114

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I'm an LTS.....I seroconverted sometime in 1992 and tested pos in December 1993.  My count was 1064 and the doc said to wait until it dropped below 400 to start meds.

About 2 years later, in September 1995, my count had dropped to 396 and I went on AZT.  A year later the protease inhibitors came out and I took Fortovase.  Six pills three times a day.  I was on Fortovase from 1996 to 2002 when I became resistant. 

AZT didn't give me any bad side effects.  I kind of wish I had gone on it before I dropped below 400, which was the "marker" back in those days.

I must say though, those protease inhibitors are why I'm here today.  :)

~ Cindy
HIV+ since '93, 1/12 - CD4 785 and undet.   WOO-HOO!!

Offline iPOZ

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  • HIV + since 1/1988 - 25 years and counting!
About 10 years ago a former doc put me on Viramune and Retrovir. The Viramune gave me a rash from head to toe and the Retrovir made me sick...so I quit taking the meds and quit going to the doc until about 2 years ago. When I returned to the doc my VL was off the charts HIGH and my CD4 count was less than 200. I was stupid to go all those years without treatment. Now I'm on Atripla and I love it. I wish I would have stayed with the meds 10 years ago. I'm 21 years positive as of Jan 2009, and hopefully with the wonderful drugs out there I'll go on for another 21 years! I'm just lucky I didn't get any OIs through those years that I wasn't on meds!

Offline Tempeboy

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Yep - if I knew then what I know now I would have started sooner.

Diagnosed 2002 - unexpected during routine medical - freaked.  Caught up the old paradigms of treatment - not to down play them but they didn't apply to my situation.

Started on a clinical trial 2005 nadir 190ish - Maraviroc and Combivir.  Soon after starting was switched to open label ( I knew what I was taking ) - I was on the once daily maraviroc - they switched me to twice daily.  After the 96 week period I switched combivir to Kivexa - I think you call it epzicom - the AZT was causing skin rash.

Now stable on Maraviroc and Kivexa ( Lamivudine and Abacavir ) - no probs - no side effects - VERY forgiving of missed and llate doses - never had a blip - no interactions with any supplements or recreational activities.  Easy to take - sometimes on an empty stomach - even empty stomach containing old beer.

I was only able to get onto this combo because this trial was available when I needed to start - not sure how I would have gone on a PI or NNRTI - which would have been the alternative options.

So if I could have started earlier with the same combo I would have.
« Last Edit: June 09, 2009, 11:16:52 PM by Tempeboy »
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 Inchlingblue

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AZT didn't give me any bad side effects.  I kind of wish I had gone on it before I dropped below 400, which was the "marker" back in those days.

The problem with taking AZT back then (before PIs came out) was that, since it was the only game in town, there were no other drugs to combine it with and AZT monotherapy is not good.

Also, very early on, maybe not by the time it was an option for you,  the dosing was off with AZT and people were prescribed doses that were too high and therefore too toxic.

So maybe it's a good thing you didn't stay on it for longer?
« Last Edit: June 10, 2009, 02:16:00 AM by Inchlingblue »

Offline lilguru

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I've been pos since 1987.  The first 14 years I did not seek treatment.  I started taking combivir and viramune in 2001 after a scare with kaposi's sarcoma in my legs.  I think at that time my t-cells were at 3 and the viral load was at 250,000.  I wouldn't do anything different.  Today my t-cell count is over 750 and my viral has been undetectable for a couple of years.  Don't get me wrong, I would not advocate anyone waiting as long as I did.  I was afraid of the treatment and could easily have died having avoided it.  You have to have good support, both health care and personal.  I was lucky early on to have a great doctor.
September 1987 - HIV+

Offline allamboy

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First time posting, so please bear with me. To answer your question, yes I would have started earlier. My head was in the sand. I knew I had to be and found out the hard way and still didn't want to face it. I was in the hospital after a heart attack and bypass at 42 (two weeks). On the last day, a little man came in, sent my family outside and told me I was HIV+ and needed to do something about it. That was it. BAM! Not only the whole heart thing happening, which was a complete surprise, but HIV+ on top of coming back from the dead. What a welcome. Not much could have been done about the heart problem as it was genetic and and had never been discovered, but I still didn't want to face being positive on top of all that as well. Stupidly I ignored it for 3 more years. It wasn't until I started developing all sorts of problems with lethargy, anemia, loss of balance that I was brought into the hospital and given treatment by a doctor who sat me down and took the shame away. Hindsight is always best, but yes, I would have and should have started earlier with what I know now. I started with 3 different meds a day and now down to 1 with my Atripla.  I was incredibly fortunate to survive my heart problems and now even more so with my HIV status. It's forums like this that make me feel I'm not alone. Thank you all.

Offline next2u

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great thread.

can you still enable the polling option so people's votes can be tallied?
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

Offline newt

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At the time no, the guidelines said 200 CD4 count, so I pushed til it was 2 tests showing a count below.

Now, yes, I'd start just before my count got to 250. No-one aspires to take meds, and certainly not take em for a long, long time, so I understand my own decision and frame of mind at the time, but in retrospect, maybe I could have had 18 months without 18 hrs/day sleep (and potentially, long term, a higher CD4 count)

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

Offline blondbeauty

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I think I started soon enough. Just 10 months after diagnosis I told my Dr. I wanted to start. My CD4 count was 503 at that moment. I was lucky to find out I was HIV+ with enough time to learn abput this infection and to make the correct decisions. Other people are not so lucky.
I owe it to my friend Felix. He was the one who took me to take the test. If not I would have probably ended having AIDS.
The only member in these forums approved by WINBA: World International Nail and Beauty Association.
Epstein Barr +; CMV +; Toxoplasmosis +; HIV-1 +.
Counts when starting treatment:
V.L.:80.200 copies. CD4: 25%=503
Started Sustiva-Truvada 14/August/2006
Last V.L.count (Oct 2013): Undetectable
Last CD4 count (OCT 2013): 52%= 933

Offline Miss Philicia

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The problem with taking AZT back then (before PIs came out) was that, since it was the only game in town, there were no other drugs to combine it with and AZT monotherapy is not good.

Also, very early on, maybe not by the time it was an option for you,  the dosing was off with AZT and people were prescribed doses that were too high and therefore too toxic.

So maybe it's a good thing you didn't stay on it for longer?

Actually Cindy was diagnosed six months after me, and at that time there were three NRTI's available: AZT, ddI (Videx/Didanosine) and ddC (Hivid/Zalcitabine).  I think it was standard by 1993 to put a patient on two HIV meds i.e. dual-therapy not mono, though officially IIRC there was no FDA approval for anything but using them alone, doctors were doing this dual stuff anyway.  Also, d4t (Zerit) would have been available to her 6 months after her diagnosis.

At the time it was also not uncommon to have patients on Hydroxyurea, which you can read about here even though it's not officially ever FDA approved.

http://www.aidsmeds.com/archive/Droxia_1901.shtml

As for me, from July 1993 until sometime in early 1996 (when Viramune and Saquinavir had FDA approval) I was on various combinations of all of this stuff.  As there was no viral load testing until (I forget exactly what time... was it 1995? and meaning where insurance would pay for it, not clinical trial use) they had to just do guess work from movements in your cd4 and % counts, and it was very much like using a divining rod.  But the difference between Cindy and I was that I was diagnosed with my first 3 tests being something more like: 215, 168, 181 (just making those numbers up but my cd4 counts were something like that).  So anyway, considering all of that I went on treatment at my 2nd lab draw, and I still think that was the correct and only decision.  

I've had to thread the needle like that at several points in my medial life, and I think I've done OK all things considered even if at times I based my decisions on gut instincts like I was at a Vegas crap table.
« Last Edit: July 12, 2009, 01:42:13 PM by Miss Philicia »
"Iíve slept with enough men to know that Iím not gay"

Offline Inchlingblue

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We now know that an all NRTI combo, whether dual or triple is not good either of course (especially those highly toxic early ones). I should have been more specific. It wasn't until the PIs came out that things started really turning around.

I have a friend diagnosed in 1985 who is still alive and doing well and only on his second line of meds (the first was discontinued for GI side effects not for resistance) and he credits his being alive with the fact that he refused AZT (and all the other early meds). The way he tells it, everyone he knew, without exception, who started on AZT died shortly thereafter. He states with conviction that if he had taken AZT he would have died for sure and who's to say he isn't right? He didn't need a clinical trial to connect the dots and see what was happening right in front of him. He was fortunate enough, unlike many others,  to have been able to hold off, but barely, until the PIs came out. There were times his Tcells dipped dangerously low during that period.  

I would also add that even though, as mentioned above, he's doing very well, never had an OI or been hospitalized, his Tcells have not cracked the 500 mark and usually hover around 350-400. He has very mild neuropathy. As far as "visible" side effects, he has a (visceral fat) belly but otherwise no lipoatrophy/distophy to speak of.

Miss P, your description of a Vegas crap table sounds very accurate, yikes. Every man (and woman) for himself, left to make decisions based on gut instincts with little and unreliable science backing any of it up.
« Last Edit: July 12, 2009, 05:49:31 PM by Inchlingblue »

Offline Miss Philicia

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I guess I should have been more clear as well -- if you were diagnosed in 1993 and went on AZT the doses were not the large ones given when it was first approved in 1987.  Not sure what year they adjusted the dosing on it however.  And while I empathize with your friend and I'm sure he believes what he says, and while I'm sure there are some that died from large doses, keep in mind that the first people that went on AZT were close to death, most having been infected for close to a decade by that time with no treatment.  That's just not a great way to measure things in a clinical manner and draw a conclusion.  And I can't emphasize enough that just the management of OIs at the time was miserable compared today.  Apples to oranges, etc.

Anyone that was diagnosed in 1985, and one would assume that they were infected years earlier, that was able to hold off treatment for an entire decade, is not in the "usual" pool and obviously was a very slow progressor.  I figure I was infected in 1988 and you can see where my numbers were five years later, which would not be that unusual.

It's hard to draw a lot of conclusions from this time period though.
« Last Edit: July 12, 2009, 05:55:45 PM by Miss Philicia »
"Iíve slept with enough men to know that Iím not gay"

Offline Inchlingblue

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Anyone that was diagnosed in 1985, and one would assume that they were infected years earlier, that was able to hold off treatment for an entire decade, is not in the "usual" pool and obviously was a very slow progressor.  I figure I was infected in 1988 and you can see where my numbers were five years later, which would not be that unusual.

It's hard to draw a lot of conclusions from this time period though.

Definitely I agree it's hard to draw conclusions.

I should have stated: my friend was actually diagnosed in 1986 but, as far as when he was exposed/infected it was 1985. He can trace it back to one bad decision during a moment of passion at St. Mark's Baths.
« Last Edit: July 12, 2009, 06:16:25 PM by Inchlingblue »

Offline Dennis

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No, I would not have started earlier. I tested 18/19 years ago, and it was recommended I start on AZT. Going against everyone's "better" judgement at that time, I chose not to. In fact, I really didn't start seeking treatment for HIV until 2002. When I finally started meds, my cd4 was 12. I'm thankful I was able to go so long without meds and am still on my first combo.

I want to add that I do not recommend. I repeat!. I do not recommend others take this course of action.

Offline Inchlingblue

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No, I would not have started earlier. I tested 18/19 years ago, and it was recommended I start on AZT. Going against everyone's "better" judgement at that time, I chose not to. In fact, I really didn't start seeking treatment for HIV until 2002. When I finally started meds, my cd4 was 12. I'm thankful I was able to go so long without meds and am still on my first combo.

I want to add that I do not recommend. I repeat!. I do not recommend others take this course of action.

wow Dennis that's interesting...what combo are  you on? Have your CD4s recovered well?

Offline Dennis

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Truvada, Reyataz, and Norvir. Prior to me going to California my CD4 was lingering close to 400, and of course, undetectable. When I moved back to Florida, I was without insurance and meds for a few months. Being without meds, along with all the stress I was put under in California made my CD4 dip down to 28. My first set of labs, 1 month after restarting meds found me undectable again, and CD4 closer to 100. I have a doctors appointment this morning to get results from my last set of labs.

Many of us have our own way of dealing with this shity disease. Some religiously track their labwork, while others maintain 100% med adherence, alter their diet, take supplements, etc. Personally, I try not to focus too much. I don't go out of my way to do what I probably would not do if I wasn't HIV+. This is what works for me.

wow Dennis that's interesting...what combo are  you on? Have your CD4s recovered well?

Offline Ann

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I've been poz for twelve years (seroconverted in May '97, but not diagnosed until February 2001) and I haven't started meds yet and I don't regret it one bit. I'm thinking I might be wise to start in the next year or so, but I really want to hold out until Raltegravir is approved for once-daily dosing in the UK. My numbers are in my profile if anyone wants to see what they've been like. Ever since I beat hep C in 2003 my VL has been pretty low. My last labs three months ago were CD4 399, 25% VL 7,390.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline clsoca

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I read a Op-Ed article in the LA times many months ago recommending persons in high risk groups to start meds while they are negative. From what I remember, the theory was to eliminate viral replication from the very beginning.

Considering the wild life I use to live that lead me to be poz and what I know now, I think I would have investigated this theory further and possibly started meds when I was neg, thus not becoming poz.

10/07 Infected
11/07 Seroconversion
07/08 Tested Poz
07/08 VL 487  CD4 658  (No Meds)
10/08 VL 286  CD4 724  (No Meds)
01/24/09 VL 30,100   CD4 329 CD4 30% (No Meds)
02/06/09 VL 44,000   CD4 367 CD4 36%  Blood Work @ UCLA (No Meds)
02/06/09 VL 44,000   CD4 317 CD4 35% Blood Work @ USC (No Meds)
02/12/09 VL 52,000   CD4 297 CD4 29%
02/12/09  Started Atripla
04/01/09 VL 60  CD4 667   CD4 48%
06-05-09  VL UD CD4 427   CD4 39%

Offline Ann

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I read a Op-Ed article in the LA times many months ago recommending persons in high risk groups to start meds while they are negative. From what I remember, the theory was to eliminate viral replication from the very beginning.

Considering the wild life I use to live that lead me to be poz and what I know now, I think I would have investigated this theory further and possibly started meds when I was neg, thus not becoming poz.


No offence to you personally, Clsoca, but that sounds like one of the stupidest ideas I've heard in a long time. If a person can't get it together to use condoms because of their "wild life", what makes you think they'd stick to a med regimen? I can't see ANY health care system, be it NHS or private insurance, paying the high cost of meds - when the alternative is a much, MUCH less expensive condom. After all, sexually speaking, the ONLY TRUE "risk group" are those people who have unprotected anal or vaginal intercourse.

I think I've heard everything now. Don't suppose you have a link? Sounds like it was written by someone who hasn't the foggiest idea about what it's like to take hiv meds every day.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Inchlingblue

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No offence to you personally, Clsoca, but that sounds like one of the stupidest ideas I've heard in a long time. If a person can't get it together to use condoms because of their "wild life", what makes you think they'd stick to a med regimen? I can't see ANY health care system, be it NHS or private insurance, paying the high cost of meds - when the alternative is a much, MUCH less expensive condom. After all, sexually speaking, the ONLY TRUE "risk group" are those people who have unprotected anal or vaginal intercourse.

I think I've heard everything now. Don't suppose you have a link? Sounds like it was written by someone who hasn't the foggiest idea about what it's like to take hiv meds every day.

Ann


What Clsoca is referring to is known as PrEP (Pre-exposure prophylaxis). It has not been proven to work but there are some studies that have indicated it could work, hence it's seriously being studied in clinical trials.

Several reputable studies so far have determined it may in fact work at preventing transmission and therefore, from a public health standpoint, may prove to be cost-effective among high-risk groups such as men who have sex with men (MSM), if it means those spared HIV are kept from triple drug cocktails for life (since PrEP usually entails taking only one of the drugs, usually tenofovir) and from exposing others, which could make the numbers of those with HIV exponentially worse.

As far as costs and adherence, one of the strategies being considered is intermittent PrEP (iPrEP), meaning if someone, say, knows they may be having a wild weekend, they'd start taking their tenofovir (or whatever) on Thursday and keep taking it for a few days. They wouldn't be taking it every day the way someone who is poz has to do.

It's a similar strategy to what's recommended with serodiscordant couples trying to get pregnant, such as Rjane and his wife. I'm pretty sure there have been some threads about PrEP in these forums. There's a website devoted to information about PrEP, link below.

Pre-exposure prophylaxis (PrEP) refers to an experimental HIV-prevention strategy that would use antiretrovirals to protect HIV-negative people from HIV infection. PrEP is not proven to work; in the strategy that is currently being tested, HIV-negative people would take a single drug, or a combination of drugs, with the hopes that it would lower the risk of infection if exposed to HIV. Along with AIDS vaccines and microbicides, PrEP is one of the experimental HIV prevention strategies being tested in clinical trials today.

LINK:

http://www.prepwatch.org/

Tenofovir for HIV Prevention: Early Results From PrEP Study Promising, but Inconclusive

LINK:

http://www.thebody.com/content/art16155.html

Got PrEP?  Adding to the HIV prevention toolkit

LINK:

http://www.xtra.ca/public/viewstory.aspx?AFF_TYPE=1&STORY_ID=4272&PUB_TEMPLATE_ID=7
« Last Edit: August 01, 2009, 06:56:08 PM by Inchlingblue »

Offline Ann

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What Clsoca is referring to is known as PrEP (Pre-exposure prophylaxis). It has not been proven to work but there are some studies that have indicated it could work, hence it's seriously being studied in clinical trials.


Arrrggg... I had it in my head for some reason that PrEP wasn't daily - and so I assumed he was talking about something else. My bad. (sorry Clsoca) (and that will teach me to post when I'm tired and have a raging headache)

I still don't think this is something that will pan out, for the reasons I stated above. And others I'm too tired to go into now.

Ann
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Inchlingblue

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Arrrggg... I had it in my head for some reason that PrEP wasn't daily - and so I assumed he was talking about something else. My bad. (sorry Clsoca) (and that will teach me to post when I'm tired and have a raging headache)


That explains it, I knew you were aware of PrEP. ;)

I get those raging headaches too. Feel better.
« Last Edit: August 01, 2009, 09:47:07 PM by Inchlingblue »

 


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