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Author Topic: Tobacco & Marijuana Found To Lower Levels of Reyataz  (Read 3142 times)

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Offline Inchlingblue

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Tobacco & Marijuana Found To Lower Levels of Reyataz
« on: September 14, 2009, 11:41:06 AM »
Tobacco and Marijuana Uses Significantly Decrease Atazanavir (ATV) Trough Concentrations in HIV Infected Individuals

LINK:

http://www.natap.org/

Note: The link above is for the Home Page. They place all new articles in Home Page and later give them their own separate links.

Online mecch

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Re: Tobacco & Marijuana Found To Lower Levels of Reyataz
« Reply #1 on: September 14, 2009, 12:56:12 PM »
Thats pretty worrisome.  Would it be avoided by twice daily dosing of Reyataz? No trough?
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Inchlingblue

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Re: Tobacco & Marijuana Found To Lower Levels of Reyataz
« Reply #2 on: September 14, 2009, 03:12:11 PM »
This is just one study and the article noted, "The investigators did not specify whether anyone was taking atazanavir without a ritonavir boost." This would be important to know.

Even though "Significantly larger proportions of tobacco and marijuana smokers had atazanavir troughs below the therapeutic range (36% for tobacco and 50% for marijuana, P < 0.05)","neither tobacco nor marijuana use had a direct effect on viral load or CD4 count in this analysis from the University of Buffalo and other centers."

It seems like the information is not enough to get too worried about but at the same time, it's probably a good idea to keep tobacco and mj  to a minimum until further notice if one is on Reyataz.

One thing about having HIV, it kind if forces one's hand as far as adopting healthy habits. Brings a whole new meaning to the phrase "do or die."


Offline newt

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Re: Tobacco & Marijuana Found To Lower Levels of Reyataz
« Reply #3 on: September 14, 2009, 05:53:21 PM »
indeed

and Smoking and Drinking Alcohol Linked to Lower Efavirenz Levels (NATAP again)


but it is slightly hard to say whether it makes any difference, the acid test is continuous undetectable viral load

it is kinda hard being lumped in with heroin uses, but i guess it's true (he sez lighting a Marlboro Light) --  my Reyataz levels are way too high day in day out but this don;t justify smoking, might justify dropping the Norvir boost tho.

it is of course important to consider the genetics here, different people process the drugs differently (see efavirenz report).

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

Offline GNYC09

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Re: Tobacco & Marijuana Found To Lower Levels of Reyataz
« Reply #4 on: September 14, 2009, 07:51:27 PM »
Note that the study has a somewhat small sample size: only 67 people. I wonder if this is adequate enough.

Also, I wonder what the implications are for Marinol although that only contains 1 of marijuana's 400 or so chemicals...
« Last Edit: September 16, 2009, 05:44:50 PM by GNYC09 »

Offline antibody

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Re: Tobacco & Marijuana Found To Lower Levels of Reyataz
« Reply #5 on: September 15, 2009, 08:50:22 PM »
Bah! I smoke more medical marijuana than an elephant and I also take Reyataz with Truvada and Norvir and I've also been known to have the occasional cigarette and I have always had an undetectable viral load so if all of these things lower Reyataz it's not enough to make a difference in my blood stream.
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 BlueMoon

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Re: Tobacco & Marijuana Found To Lower Levels of Reyataz
« Reply #6 on: September 16, 2009, 10:12:06 AM »
Interesting, since it took me seventeen months to get to undetectable on Reyataz and reefer.

Inchlingblue, the article I found indicates that the Reyataz was most likely boosted: "from Jules: I spoke with authors about this study. I asked author if all were using ritonavir boosted ATV and I think they said yes."
...................VL.....CD4.....%
-----------------------------------------
08/10-- ......<40.....290.....42
05/10-- ......<48.....290.....46
02/10-- ......<48.....481.....44
10/09-- ......<48.....277.....46
07/09-- ......<48.....300.....38
05/09-- ........51.....449.....39
03/09-- Added Isentress
02/09-- ........65.....299.....34
11/08-- ........62.....242.....40
08/08-- ........66.....212.....29
05/08-- ......202.....217.....27
03/08-- ....5210.....187.....21
02/08-- Began Truvada/Reyataz/Norvir
12/07-- 273,000.....157.....22
11/07-- 229,000.....209.....22
10/07-- Diagnosis

It's a complex world.

Offline risred1

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Re: Tobacco & Marijuana Found To Lower Levels of Reyataz
« Reply #7 on: September 16, 2009, 12:59:05 PM »
We all know that smoking isn't a good thing when your poz....

So I'm through with cigs, which was a social thing with me, but at times, enough to where I would smoke for several days in a row...

Its time to say enough. Certainly, I know I don't feel as well when I'm smoking, so its the right thing to do regardless.

As to reefer... shoot! Its only an occasional thing with me, but with that, I'll just keep it occasional. I wonder if a vaporizer makes any difference?
« Last Edit: September 16, 2009, 10:22:29 PM by risred1 »
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 antibody

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  • "every man thinks his burden is the heaviest"
Re: Tobacco & Marijuana Found To Lower Levels of Reyataz
« Reply #8 on: September 20, 2009, 09:46:52 PM »
well for the 3 years I've been on the combo I've been undetectable since my first blood draw and every draw since I've also smoked copious amounts of cannabis while on this combo and have no plans to change my intake. I also consume nicotine * this may not work for all*
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 BM

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Re: Tobacco & Marijuana Found To Lower Levels of Reyataz
« Reply #9 on: September 21, 2009, 03:58:09 PM »
This is upsetting. I enjoy the occasional cigarette and a more than the occasional joint. I'm not prepared to take the risk: I like my current combination and don't want to develop resistance for the sake of a few ciggies. I'm not even sure what would be left in the HAART bag for me to take!

Offline antibody

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  • "every man thinks his burden is the heaviest"
Re: Tobacco & Marijuana Found To Lower Levels of Reyataz
« Reply #10 on: September 22, 2009, 11:45:13 PM »
I'm sure it's just propaganda from the anti medical marijuana establishment trying to scare poor aids patients into stopping cannabis.  Freckin' RepubliCONS
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 risred1

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Re: Tobacco & Marijuana Found To Lower Levels of Reyataz
« Reply #11 on: September 23, 2009, 09:28:36 AM »
Marijuana    Protease Inhibitors (PI) and Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI)    

Smoked marijuana may lower PI and NNRTI levels. Smoked THC in one study decreased NFV by 17% and IDV by 21%.7    

THC interferes with CYP3A4, 2C9, and 2D6. Increases in THC if using medications that inhibit CYP450; decreases in THC if using medications that induce CYP450.

I found this information at thebody.com

http://www.thebody.com/content/art32513.html

----

This I'm sure is based upon the study that was published that of course indicates that further study is warranted. I'm not so sure that we can attribute this to a anti marijuana lobby. My opinion is that we shouldn't pretend just because we don't like the news. And I understand as a herbal user myself. I'm doing well on my regimine. So, perhaps the occasional "hit" that may reduce the PI level, may be well with tolerence level of say, missing an occasional dose or taking meds late, etc.

I also know that the med marijuana folks are really pushing legalized pot in one form or another. Pot helps for sure with a host of issues, but lets not pretend we are always talking about POT as a totally healthy thing to do with no ramifications or issues with getting high.
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 BM

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Re: Tobacco & Marijuana Found To Lower Levels of Reyataz
« Reply #12 on: September 24, 2009, 12:07:03 AM »
Can someone suggest an alternative to smoking and drinking that's HAART friendly?! I needs me my little crutches!

Offline antibody

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  • "every man thinks his burden is the heaviest"
Re: Tobacco & Marijuana Found To Lower Levels of Reyataz
« Reply #13 on: September 26, 2009, 09:59:56 PM »
well let me just put it this way. Without Cannabis I am as good as dead. I have no quality of life without Cannabis so I will never NEVER EVER be out of cannabis so, so be it if it lowers the levels of drugs all I can say is oh well.
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 newt

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  • the one and original newt
Re: Tobacco & Marijuana Found To Lower Levels of Reyataz
« Reply #14 on: September 27, 2009, 03:01:31 PM »
Quote
Can someone suggest an alternative to smoking and drinking that's HAART friendly?

erm, shagging?
"The object is to be a well patient, not a good patient"

Offline BM

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Re: Tobacco & Marijuana Found To Lower Levels of Reyataz
« Reply #15 on: September 28, 2009, 12:41:19 PM »
erm, shagging?

 :D I arguably get too much of that already!

Offline risred1

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Re: Tobacco & Marijuana Found To Lower Levels of Reyataz
« Reply #16 on: September 28, 2009, 02:31:28 PM »
antibody...

Hey,,,

I hear ya... and I'm not doing anything different.

I'm not here to suggest you do otherwise with the information we have been presented.

is it the THC? or something else... Is smoking different that Vaporizing...

There are things to consider... They didn't say what the usage was. (daily or whatever), they don't suggest if there is a way to compensate.

And its not mentioned what the impact to therapy really is, if any.

Obviously the quality of our life is ours alone to judge. This is just information in the end, and we will have to make up our own minds as to what we want or need to do.

I just don't want to go to that place where MJ is a totally healthy thing to do. Or that there never is an issue, or consequence consuming an intoxicant. Even prescription drugs have their own list of side effects and ramifications. Same with HIV meds. Same with Food that we eat. What we drink. The way we live.

The expectation that as people who live with HIV have to be "better" than our Negative peers is an undercurrent to our condition. There are some of us who are saints, models of what can be done, shiny examples of a certain ability to focus and execute a plan. And then there is the rest of us.

I'm no saint myself for sure. Should I eat better? Loose more weight? get more exercise? quit doing stuff?

Sure. But the stuff I do try to do is at least something. Having Awareness is something. Trying to find a way etc. its all part of the process.

I was quite a pot head in college, and smoked everyday. After a certain point, my tolerance got so high that I really couldn't get high, felt like crap, and needed to take a break. My friends were all shocked that I went on a 100 day clean out, and were surprised when I actually was able to do so. The point is, one makes ones own decision, and what you say today, might be different tomorrow. There's nothing wrong with any of that.

Even now, with the vaporizer, I save that for more or less special occasions. With this information, I'm just now more aware of what I should be looking for in my tests, and if there is a blip, maybe I'll alter my habits to see if that helps.

This is just a bit of news on the old HIV front, we get some everyday. We don't react to everything anymore nor should we. Its just more and more stuff we have to sort though. Until we start getting more definitive information and if one is doing just fine and smokes herb, I don't know if its something to truly be worried about. Maybe just to monitor.

:)

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 antibody

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  • "every man thinks his burden is the heaviest"
Re: Tobacco & Marijuana Found To Lower Levels of Reyataz
« Reply #17 on: September 28, 2009, 07:59:54 PM »
well my research is in. 3 years on the combo no blips, always undetectable and always Lifted on marijuana. So for me this is not a concern and I will move on. Research complete.
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 risred1

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Re: Tobacco & Marijuana Found To Lower Levels of Reyataz
« Reply #18 on: September 29, 2009, 08:32:44 AM »
I just noticed your outstanding CD4 count and Undetectable Status. It doesn't surprise me that Herb may not have much of an impact.

It may be more of a concern for us with lower counts. Where we have less margin for error.

Regardless.... good for you!

;)
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

 


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