Quantcast

Subscribe to:
POZ magazine
Newsletters
Join POZ: Facebook MySpace Twitter Pinterest
Tumblr Google+ Flickr Instagram
POZ Personals
Sign In / Join
Username:
Password:
Welcome, Guest. Please login or register.
December 20, 2014, 12:58:33 AM

Login with username, password and session length


Members
  • Total Members: 24258
  • Latest: ter353
Stats
  • Total Posts: 649957
  • Total Topics: 49610
  • Online Today: 158
  • Online Ever: 585
  • (January 07, 2014, 02:31:47 PM)
Users Online

Welcome


Welcome to the POZ/AIDSmeds Community Forums, a round-the-clock discussion area for people with HIV/AIDS, their friends/family/caregivers, and others concerned about HIV/AIDS.  Click on the links below to browse our various forums; scroll down for a glance at the most recent posts; or join in the conversation yourself by registering on the left side of this page.

Privacy Warning:  Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If you are HIV positive and disclose this in our forums, then it is almost the same thing as telling the whole world (or at least the World Wide Web). If this concerns you, then do not use a username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.

  • The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own physician.

  • All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.

  • Forums members must behave at all times with respect and honesty. Posting guidelines, including time-out and banning policies, have been established by the moderators of these forums. Click here for “Am I Infected?” posting guidelines. Click here for posting guidelines pertaining to all other POZ/AIDSmeds community forums.

  • We ask all forums members to provide references for health/medical/scientific information they provide, when it is not a personal experience being discussed. Please provide hyperlinks with full URLs or full citations of published works not available via the Internet. Additionally, all forums members must post information which are true and correct to their knowledge.

  • Product advertisement—including links; banners; editorial content; and clinical trial, study or survey participation—is strictly prohibited by forums members unless permission has been secured from POZ.

To change forums navigation language settings, click here (members only), Register now

Para cambiar sus preferencias de los foros en español, haz clic aquí (sólo miembros), Regístrate ahora

Finished Reading This? You can collapse this or any other box on this page by clicking the symbol in each box.

Author Topic: When to Push for Meds?  (Read 4583 times)

0 Members and 1 Guest are viewing this topic.

Offline northernguy

  • Member
  • Posts: 1,347
When to Push for Meds?
« on: October 08, 2009, 12:19:01 AM »
Latest labs still showing OK results, though the cd4% of 16 ain't great. CD4 580 vl 45k.

My doc is in no rush to put me on meds, but I'm still plagued with skin issues, which have worsened over the last month.  From what I understand there is really no "cure" for the seborrheic dermatitis I've got, so the only real shot at resolving it is HAART (and that's no guarantee).

I'm interested in other folks opinions:  would you push for meds now or hold out until the numbers worsen?
« Last Edit: October 08, 2009, 12:21:24 AM by northernguy »
Apr 28/06 cd4 600 vl 10,600 cd% 25
Nov 8/09 cd4 510 vl 49,5000 cd% 16
Jan 16/10 cd4 660 vl 54,309 cd% 16
Feb 17/10 Started Atripla
Mar 7/10 cd4 710 vl 1,076 cd% 21
Apr 18/10 cd4 920 vl 268 cd% 28
Jun 19/10 cd4 450 vl 60 cd% 25
Aug 15/10 cd4 680 vl 205 cd% 27
Apr 3/11 cd4 780 vl <40 cd% 30
Jul 17/11 cd4 960 vl <40 cd%33
April 15/12 cd4 1,010 vl <40 cd% 39
April 20/12 Switched to Viramune + Truvada
Aug 2/12 cd4 1040, vl <40, cd% 38
Oct 19 cd4 1,110 vl <40 cd% 41

Offline Assurbanipal

  • Member
  • Posts: 2,173
  • Taking a forums break, still see PM's
Re: When to Push for Meds?
« Reply #1 on: October 08, 2009, 01:10:15 AM »
Look at the numbers remembering that there is a lot of random noise.  Changes are only significant if:
viral load varies 3 fold
CD4 count varies more than 30% (multiplicative)
CD4 % varies more than 3% (additive)

That said, it looks like your viral load took a significant step up in 2008 and your tcell count and percentage took a significant step down in your recent tests. 

Are you mentally ready to stick with it if you start?  If so, I'd give it a try.  Course, I'm biased having seen how bad it gets if you don't start til you are sick.

But it certainly doesn't look urgent.

It's a difficult decision. 

Best wishes

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 bocker3

  • Member
  • Posts: 3,458
  • You gotta enjoy life......
Re: When to Push for Meds?
« Reply #2 on: October 08, 2009, 07:48:07 AM »
If those results were mine, I would start meds.  HOWEVER, the decision for you to to start is not mine, nor is it, ultimately, the docs, it is yours.  Certainly you should consult with and consider his/her advice, but the decision is yours.
Are you ready to start?  If so, have a discussion with the doctor, but don't frame it as "should I", frame it in the way you wish to move.
As for your seborrheic dermatitis, I had terrible case of it.  It did improve, somewhat, when I start HAART, but I did not get it under control until I saw a dermatologist and he gave me a prescription for Desowen creme.  I used it 2x a day for a couple of weeks and now I use it 2x a WEEK and my face is completely clear.

Good luck,
Mike 
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2013 691/31% <20

Offline Nashvegas

  • Member
  • Posts: 196
Re: When to Push for Meds?
« Reply #3 on: October 08, 2009, 10:32:19 AM »
Hey Northernguy -- I think if I were in your shoes, I'd be pushing to start.

It seems to me that the 350-500 CD4 threshold for starting is really aimed at people who are not experiencing other problems due to their HIV.  You've certainly experienced more than your share of significant skin issues for someone with a relatively high CD4 count.  That would certainly weigh on my psyche and overall mental state, which, in turn, and also might be contributing to the weight gain you've experienced. 

I say, if you're ready, grab the bull by the horns and figure out which combo you'd like to start with.  But it's up to you...   
8/12/06 - sero-conversion
9/14/06 -- Positive Test results confirmed
9/21/06 -- CD4 - 586; viral load 8,000; 29%
12/25/06 -- CD4 - 373; VL 2,800; 23%
2/10/07 - CD4 - 228; VL 865; 25%
3/15/07 -  CD4 - 365 (no viral load test)
5/1/07 = CD4 - 341; VL 4,358; 27%
8/1/07 - CD4 - 315; VL - 2,300; 25%
9/20/07 - CD4 - 378
11/22/07 - CD4 - 257; VL 7,300;
2/27/08 - CD4 231 (16.5 %), VL 5,960
5/20/08 - CD4 229 (18.3%), VL 11,100
6/17/08 - CD4 166 (14.5%), VL 9,030
6/17/08 - STARTED VIRAMUNE + TRUVADA
7/2/08 - CD4 272 (20%), VL 113  :-)
7/16/08 - CD4 -217 (21.1 %), VL - Undetectable
7/30/08 - CD4 - 220 (20.4%). VL - 92
8/14/08 - CD4 - 280 (22%) VL-undetectable
1/04/09 - CD4 - 250 (28%) VL-UD
5/15/09 - CD4 -393 (28%) VL-UD
8/15/09 - CD4-346, (26%) VL-UD
11/15/09 - CD4-373 (28%)

Offline ALH300

  • Member
  • Posts: 69
  • Some days ur the bug other days ur the windshield!
Re: When to Push for Meds?
« Reply #4 on: October 08, 2009, 11:53:02 AM »
I had a lot of skin and mouth issues (thrush/leukoplakia)before I started meds. My lowest % was 14.5, remember anything under 14% is an AIDS diagnoses. Within 2 months of starting meds my problems cleared up and have had no problems since.
Poz 7-27-07 
First Labs:
07/13/2007 "Friday the 13th" What was I thinking???
314 CD4 17% 9410 VL
10/03/2007
479 CD4 18% 8220 VL
01/03/2008
493 CD4 22.5 % 5900 VL
03/18/2008
432 CD4 14.4 % 11,830 VL
05/06/2008
480 CD4 15.0% 2630 VL
07/16/2008
361 CD4 16.4% 12,830 VL
10/31/2008
362 CD4 15.5% 2500 VL
Started Atripla 11-17-2008
1/16/2009
395 CD4 20.5% undect. VL
5/05/2009
426 CD4 20.3% undect. VL
9/15/2009
422 CD4 22.2% undect. VL

Offline mecch

  • Member
  • Posts: 12,165
  • red pill? or blue pill?
Re: When to Push for Meds?
« Reply #5 on: October 08, 2009, 02:35:13 PM »
If I were you, I'd take HAART.  Skin issues point to continued immune overdrive and inflammation. 
Is EVERYTHING else A OK, or are there other "issues" as well?
Can you afford HAART for the long run, and stick to it?
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline northernguy

  • Member
  • Posts: 1,347
Re: When to Push for Meds?
« Reply #6 on: October 09, 2009, 02:13:00 AM »
Thanks for the input.  Keep it coming.

I'm torn.  On the one hand the VL is climbing, but on the other cd4's are where they were three years ago.  The supposedly stable cd4% seems to bounce around a fair amount in my case.
Apr 28/06 cd4 600 vl 10,600 cd% 25
Nov 8/09 cd4 510 vl 49,5000 cd% 16
Jan 16/10 cd4 660 vl 54,309 cd% 16
Feb 17/10 Started Atripla
Mar 7/10 cd4 710 vl 1,076 cd% 21
Apr 18/10 cd4 920 vl 268 cd% 28
Jun 19/10 cd4 450 vl 60 cd% 25
Aug 15/10 cd4 680 vl 205 cd% 27
Apr 3/11 cd4 780 vl <40 cd% 30
Jul 17/11 cd4 960 vl <40 cd%33
April 15/12 cd4 1,010 vl <40 cd% 39
April 20/12 Switched to Viramune + Truvada
Aug 2/12 cd4 1040, vl <40, cd% 38
Oct 19 cd4 1,110 vl <40 cd% 41

Offline esper

  • Member
  • Posts: 57
Re: When to Push for Meds?
« Reply #7 on: October 11, 2009, 06:14:07 AM »
Hi Northernguy / All, hope you don't mind a newbie posting here, but this is the million dollar topic for me now too. I 'm just a few months into post+ life, but starting to wrestle with this issue too. I've been having all sorts of skin problems as well, mostly rashes that come and go (good success with topicort and some other skin creams from the derm). My doc has been telling me that more and more the treatment wisdom is to start meds earlier rather than later - before CD4 reaches 350 if possible (rather than 250 as is current recommendation) - but your numbers look quite good (and have for years!).  He does say better chance for skin problems to improve when on meds (after getting stabilized), but makes no promises (could be allergies, etc). Great information on this thread, thanks for starting it...and I wish you good luck with your decision.  esper
tested positive June 26, 2009
06/26/2009-CD4 428: VL 56,200: 34.1%
09/28/2009-CD4 388: VL 105,000: 31.9%
11/16/2009-CD4 330: VL 242,000: 23.4%
12/11/09 started stocrin (sustiva) & truvada
02/02/2010-CD4 588: VL 204: 31.6%
04/27/2010-CD4 620; VL 154; 38.5%
08/25/2010-CD4 504; VL undet; 39.2%
11/16/2010-CD4 499: VL undet: 44.6%
03/01/2011-CD4 534: VL undet: 33.2%
06/01/2011-CD4 709: VL undet: 45.6%
12/11/2011-CD4 537: VL undet: 41.5%
06/10/2012-CD4 597: VL undet: 42.8%

Offline Life

  • Member
  • Posts: 2,388
  • Member 2005
Re: When to Push for Meds?
« Reply #8 on: October 11, 2009, 10:34:29 AM »
I think your body is telling you what it needs...  Listen to it..  At 14%, I would get started.  My skin problems reversed themselves in a months time and no more of that crap.  Its a committment and you have been dancing around this for awhile.  I had 5 weeks from diagnosis to getting started.  You have alot of head knowledge now...  Then, what is your doctor saying or recomending??

Hugs,

Eric

Offline confidentIwillbeOK

  • Member
  • Posts: 131
Re: When to Push for Meds?
« Reply #9 on: October 11, 2009, 11:08:21 AM »
Northernguy, to mirror what Mecch said my doctor told me and my partner this week "remember...HIV is a HIGHLY HIGHLY inflammatory condition".  He said the inflammation, left untreated, could lead to other more significant issues down the road. 

He also said the CDC will be changing the treatment guidelines in the very near future (Nov. maybe) to say CD4 counts between 350 and 500 would change from "consider treatment" to "strongly consider or strongly suggest treatment".  The pendulum, as many have told me, is swinging toward treating earlier.  This is obviously mostly due to the availability of effective drugs with manageable side effects.  Given the new guidelines you may want to think again about possibly starting even though you are still now in the "consider" range.

BTW, the other half took his second dose of Atripla last night and has had 0 side effects thus far.  He woke up today and said in a joking way "I was ripped off...no wild dreams....no nothing!".  He is now very happy he started treatment "early" and has no regrets. 

Best,
Steve
 

Offline northernguy

  • Member
  • Posts: 1,347
Re: When to Push for Meds?
« Reply #10 on: October 11, 2009, 01:42:28 PM »
I think your body is telling you what it needs...  Listen to it..  At 14%, I would get started.  My skin problems reversed themselves in a months time and no more of that crap.  Its a committment and you have been dancing around this for awhile.  I had 5 weeks from diagnosis to getting started.  You have alot of head knowledge now...  Then, what is your doctor saying or recomending??

Hugs,

Eric

My docs a strong believer in cd4 count as the call to start, taking into account the viral load.  He's also wary of the fact there still aren't really long-term studies of the effects of currently used meds on the body. 
Apr 28/06 cd4 600 vl 10,600 cd% 25
Nov 8/09 cd4 510 vl 49,5000 cd% 16
Jan 16/10 cd4 660 vl 54,309 cd% 16
Feb 17/10 Started Atripla
Mar 7/10 cd4 710 vl 1,076 cd% 21
Apr 18/10 cd4 920 vl 268 cd% 28
Jun 19/10 cd4 450 vl 60 cd% 25
Aug 15/10 cd4 680 vl 205 cd% 27
Apr 3/11 cd4 780 vl <40 cd% 30
Jul 17/11 cd4 960 vl <40 cd%33
April 15/12 cd4 1,010 vl <40 cd% 39
April 20/12 Switched to Viramune + Truvada
Aug 2/12 cd4 1040, vl <40, cd% 38
Oct 19 cd4 1,110 vl <40 cd% 41

Offline newt

  • Member
  • Posts: 3,887
  • the one and original newt
Re: When to Push for Meds?
« Reply #11 on: October 11, 2009, 04:12:51 PM »
CD4 count is generally fine for starting treatment, but a CD% of aroun 12-13% should equate a count of 200, and a cd4% around your level equate to about the count treatment is recommended in current guidelines. This said, CD4 count is more predictive of risk of opportunistic infections, it seems. All this said, I reckon, makes it your (difficult) call

With CD4 counts and treatment there's nothin to believe in, it's what the studies says, and what you make of it.

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

Offline bufguy

  • Member
  • Posts: 161
Re: When to Push for Meds?
« Reply #12 on: October 12, 2009, 03:38:56 PM »
It is definitely an individual decision, but as I have posted before, I started with CD4 of 511 and Vl of 47,500 on Atripla and I have absolutely no regrets. 100% adherent BTW.
I had side effects for only the first week. After that it has been a breeze.
My feeling was, why wait? I would have to start in another year or two, and as others have said the imflamation created by the virus is becoming more of a concern.
Plus I feel I am in control now. I'm not sitting waiting.
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 northokguy

  • New Member
  • Posts: 1
Re: When to Push for Meds?
« Reply #13 on: October 14, 2009, 02:08:14 PM »
while your CD4 count is in the good range I would go ahead and push to start HAART. I reason is why let the VL be that high?  Get you VL down to under 50 copies and your CD4/CD8 % will get better.  There is no reason to wait for all hell to break loose before starting meds. 
good luck

Offline andrewbrobinson

  • New Member
  • Posts: 2
Re: When to Push for Meds?
« Reply #14 on: October 14, 2009, 02:25:58 PM »
I'm in a similar situation.  Labs are similar with a bit lower vl.  I don't have the skin probs but other issues such as apthous ulcers (often too many to count) and fatigue.  My md mentioned therapy as well as an option without any guarantee it will help the above (of course.)

For whatever it's worth, it is a tough decision for me also.  At this time, I am choosing to not start meds.  That is not to say I have any confidence that my decision is right or wrong.  It's just my decision at this time.  If clinical protocols change as one of our fellow members indicated, my decision will be much easier.

I know I probably wasn't much help but maybe knowing others are at a very similar place is helpful...hope it is.

AR

Offline pos2007

  • Member
  • Posts: 116
Re: When to Push for Meds?
« Reply #15 on: October 14, 2009, 10:08:30 PM »
There  is  a growing number  of studies  that say  the  higher  the  CD4   the less  chance of you developing infections  and  cancers. I  wasn't  even  diagnosed  until 138.  . My wife wasn't  diagnosed till < 20 with a viral  load  of  500,000.   Trust  me, You  never  want  to get  close  to  being there.  The  meds arn't as bad as  fighting  to  live. A lot  of plans  will  not  pay  for  meds  till  you get to 350  or  below. When   I  started 2  years ago  that  threashold  was 200 but  they  found  out  200 was too  low  and  too  late.   If you  have a way  to  pay for  meds  at a CD4 above 500,  I  would  go  for   it.  The chances  you  take  for  opportuninistic  infections are too  high otherwise.  I've  been  through  the  cancer  bit. My wife  has  been  through  the   pneumonia  and  other infections.  It  also  harder to   get  your immunity  back  once it  has  been decimated.  Once  your  viral  load starts  going  up,  it  can  go  up  rapidly.  I  have seen   a 100,000  jump in  my  wife  in  one  month.   2 cents  worth   for  free.  Been  there. 
Diagnosed  CD4 138 VL. 38,000
Partner Diagnosed CD4 <20  VL.  488,000

Offline pos2007

  • Member
  • Posts: 116
Re: When to Push for Meds?
« Reply #16 on: October 14, 2009, 10:12:36 PM »
I  was asked  to post  this by others  that  read  your  posts.  Find  an  HIV experienced  doctor.
Diagnosed  CD4 138 VL. 38,000
Partner Diagnosed CD4 <20  VL.  488,000

Offline positively_me

  • Member
  • Posts: 87
  • love me...love my monkey
Re: When to Push for Meds?
« Reply #17 on: October 14, 2009, 10:41:02 PM »
i've never had a viral load over 9k but yet my cd4% have gone as low as 12%. my t-cells were around 300 - 400 at the time.  it seems like each one of our bodies acts differently with the hiv so i can't understand why your doctor would only want to take your t-cell count into consideration.  for me, getting thrush, a horrendous sinus infection and then a few bouts of MRSA all in 9 months time was enough for me to decide to go on meds. while it is valid to worry about long term side effects from the meds, you don't want your immune system to be so worn down that it will be harder to get healthy once you start taking them.
Great minds discuss ideas; Average minds discuss events; Small minds discuss people.  - Eleanor Roosevelt

Offline northernguy

  • Member
  • Posts: 1,347
Re: When to Push for Meds?
« Reply #18 on: October 14, 2009, 11:35:47 PM »
I  was asked  to post  this by others  that  read  your  posts.  Find  an  HIV experienced  doctor.

My doc is very experienced in treating HIV.  Having been on the frontlines for quite a while, I think he's leery of some of the side effects of the HIV meds, especially given that we may be taking them now for decades.

I forgot to add that thankfully med cost and insurance issues aren't a factor as the universal healthcare system in British Columbia covers all of that.

Edited to add: adherence shouldn't be an issue either, I've been on blood pressure and acid reflux meds for years, with no problems.
« Last Edit: October 14, 2009, 11:56:38 PM by northernguy »
Apr 28/06 cd4 600 vl 10,600 cd% 25
Nov 8/09 cd4 510 vl 49,5000 cd% 16
Jan 16/10 cd4 660 vl 54,309 cd% 16
Feb 17/10 Started Atripla
Mar 7/10 cd4 710 vl 1,076 cd% 21
Apr 18/10 cd4 920 vl 268 cd% 28
Jun 19/10 cd4 450 vl 60 cd% 25
Aug 15/10 cd4 680 vl 205 cd% 27
Apr 3/11 cd4 780 vl <40 cd% 30
Jul 17/11 cd4 960 vl <40 cd%33
April 15/12 cd4 1,010 vl <40 cd% 39
April 20/12 Switched to Viramune + Truvada
Aug 2/12 cd4 1040, vl <40, cd% 38
Oct 19 cd4 1,110 vl <40 cd% 41

Offline deibster

  • Member
  • Posts: 155
Re: When to Push for Meds?
« Reply #19 on: October 15, 2009, 12:43:24 AM »
Hi, there are other considerations. There are alot of people at my ASO in the 50 to 70 year old range. The newest research says that starting HART earlier, around CD4 500, has the best chance for a long life. I know that this seems a long way off to most of you, but it does come around. I'm knew to the site, but I've been Poz for 16 years & wish that I started treatment Earlier than I did. Hugs, deibster
Poz since Dec 1992. Meds since 1995. Disability since 2005.

Prezista/Norvir, Epzicom, Cytomel, Prevacid, pravastatin, Fenofibrate, Remeron, Zoloft, Concerta, doxazosin, Allegra180, Nasocort, Centrum, Flax Oil, Fish Oil

Offline pos2007

  • Member
  • Posts: 116
Re: When to Push for Meds?
« Reply #20 on: October 15, 2009, 08:35:42 PM »
northernguy,  there are  many  treatment  options  now that minimize  the  side effects.  I  have seen with  my  own  eyes  that  people  react very  different with different regimens.  My wife is on  her  third  and  the best  one  yet!  ;) My doctor offered to  change  mine  today  if  I  wanted(declined)  due to  a drug  interaction  problem ( new  med I  am  trying  to  add to  the  pile  of  meds I already  take)  and because I  am  having  trouble swallowing  the  large  pill because  of  my  throat surgery.  Some times  it  takes  a long  time  for  your  body to adjust  to  the  meds.;  sometimes  not. My   wife's  latest  less  than  a week,  Mine  almost  a year,   but  the  meds are VERY doable.  Don't  let  the virus  win or get a good grasp on  you.  The  " control"  ( no   drug)  group  in the  long  term studies are  dead.  There is  always  the  option  of  changing  to   a better  med as  they  come  available.  It  is  your   job  to stay  alive  to  have  that opportunity. Kudos to  universal  healthcare!!!! U.S.A. needs  to  get  with  the  program.
« Last Edit: October 15, 2009, 08:37:56 PM by pos2007 »
Diagnosed  CD4 138 VL. 38,000
Partner Diagnosed CD4 <20  VL.  488,000

Offline northernguy

  • Member
  • Posts: 1,347
Re: When to Push for Meds?
« Reply #21 on: October 15, 2009, 10:26:37 PM »
Well, because of my oral hairy leukoplakia diagnosis my doc and I had a long talk about it today.  He still thinks I can hold off, but asked if I felt psychologically ready to start.  I think I'll go in for an early set of labs in Nov., two months after the last ones.  The most commonly used first line treatment here is apparently Viramune + Truvada.
Apr 28/06 cd4 600 vl 10,600 cd% 25
Nov 8/09 cd4 510 vl 49,5000 cd% 16
Jan 16/10 cd4 660 vl 54,309 cd% 16
Feb 17/10 Started Atripla
Mar 7/10 cd4 710 vl 1,076 cd% 21
Apr 18/10 cd4 920 vl 268 cd% 28
Jun 19/10 cd4 450 vl 60 cd% 25
Aug 15/10 cd4 680 vl 205 cd% 27
Apr 3/11 cd4 780 vl <40 cd% 30
Jul 17/11 cd4 960 vl <40 cd%33
April 15/12 cd4 1,010 vl <40 cd% 39
April 20/12 Switched to Viramune + Truvada
Aug 2/12 cd4 1040, vl <40, cd% 38
Oct 19 cd4 1,110 vl <40 cd% 41

Offline Nashvegas

  • Member
  • Posts: 196
Re: When to Push for Meds?
« Reply #22 on: October 15, 2009, 10:38:04 PM »
I'm on Viramune + Truvada and love the combo.  A word of warning though -- a small but significant  percentage of people on this combo end up with a rash in the first couple of weeks, which often resolves, but forces some people to go off the meds.  I don't know if you're more likely to experience that rash because of the skin issues you've dealt with, but it's something to be aware of.  But this combo has literally been without any negative side effects for me, and I'm really glad I'm on it. 
8/12/06 - sero-conversion
9/14/06 -- Positive Test results confirmed
9/21/06 -- CD4 - 586; viral load 8,000; 29%
12/25/06 -- CD4 - 373; VL 2,800; 23%
2/10/07 - CD4 - 228; VL 865; 25%
3/15/07 -  CD4 - 365 (no viral load test)
5/1/07 = CD4 - 341; VL 4,358; 27%
8/1/07 - CD4 - 315; VL - 2,300; 25%
9/20/07 - CD4 - 378
11/22/07 - CD4 - 257; VL 7,300;
2/27/08 - CD4 231 (16.5 %), VL 5,960
5/20/08 - CD4 229 (18.3%), VL 11,100
6/17/08 - CD4 166 (14.5%), VL 9,030
6/17/08 - STARTED VIRAMUNE + TRUVADA
7/2/08 - CD4 272 (20%), VL 113  :-)
7/16/08 - CD4 -217 (21.1 %), VL - Undetectable
7/30/08 - CD4 - 220 (20.4%). VL - 92
8/14/08 - CD4 - 280 (22%) VL-undetectable
1/04/09 - CD4 - 250 (28%) VL-UD
5/15/09 - CD4 -393 (28%) VL-UD
8/15/09 - CD4-346, (26%) VL-UD
11/15/09 - CD4-373 (28%)

Offline SoSadTooBad

  • Member
  • Posts: 248
Re: When to Push for Meds?
« Reply #23 on: October 17, 2009, 02:53:44 AM »
If you have access to the meds and can adhere to the regimen - S T A R T.   You will not regret it.

Offline TopherK

  • Member
  • Posts: 13
Re: When to Push for Meds?
« Reply #24 on: October 31, 2009, 12:32:09 PM »
Northernguy -

I'm interested in hearing more about whether you've started treatment and if it has had any effect on your skin condition.  I've been dealing with what has alternately been called Eosinophilic Folliculitis or Grover's Disease for three years.  In either case it is an unsightly and intensely itchy rash that covers my back, chest and shoulders.  Among the myriad treatments I've had, oral prednisone is the ONLY one that has brought any relief.  After looking for bacteria, parasites, fungus (five biopsies) there is still no definitive diagnosis.

As a result, my ID doctor and I decided yesterday that it was probably time to start HAART as soon as my resistance profile test comes back.  I've been delaying this decision as long as I can since my liver is damaged from years of heavy drinking and an unfortunate encounter with fulminate Hep B nearly 10 years ago. Having almost a year of sobriety under my belt, though, my liver function numbers are finally rock solid and will hopefully not go too out of whack if I start treatment.

I can't find any literature that advises differently since it clearly appears that I'm dealing with inflammation and immune response issues. An additional plus of starting on Truvada is that it will mitigate any Hep B reactivation that could be caused by a longer course of prednisone.  Still, I'm bummed to have to start meds with numbers that are otherwise stellar.

So - what has your experience been... any luck?
Diagnosed August 17, 2005
12 Jul  07 v/l 722   CD4 558  31%
10 Oct 07 v/l 1132  CD4 456  21%
08 Feb 08 v/l <50!  CD4 510  30%
09 May 08 v/l 1128  CD4 669  30%
06 Aug 08 v/l 1126  CD4 618  29%
06 Dec 08 v/l 248    CD4 630  30%
01 May 09 v/l 2626  CD4 529  28%
05 Jul 09 v/l 2616    CD4 524  28%
21 Oct 09 v/l 4201  CD4 763  30%
19 Nov 09 - start Truvada/Reyataz/Norvir & Predisone for chronic inflammation
11 Dec 09 v/l 114    CD4 700  31% - switch Reyataz/Norvir to Isentress
currently  v/l <50  CD4 ~560  30%

Offline northernguy

  • Member
  • Posts: 1,347
Re: When to Push for Meds?
« Reply #25 on: November 03, 2009, 12:00:04 AM »
Northernguy -

I'm interested in hearing more about whether you've started treatment and if it has had any effect on your skin condition. ...
So - what has your experience been... any luck?


I'm going to bump my labs up to every 2 months instead of 3.  Next ones are in a couple or weeks, we'll see what the results are.
Apr 28/06 cd4 600 vl 10,600 cd% 25
Nov 8/09 cd4 510 vl 49,5000 cd% 16
Jan 16/10 cd4 660 vl 54,309 cd% 16
Feb 17/10 Started Atripla
Mar 7/10 cd4 710 vl 1,076 cd% 21
Apr 18/10 cd4 920 vl 268 cd% 28
Jun 19/10 cd4 450 vl 60 cd% 25
Aug 15/10 cd4 680 vl 205 cd% 27
Apr 3/11 cd4 780 vl <40 cd% 30
Jul 17/11 cd4 960 vl <40 cd%33
April 15/12 cd4 1,010 vl <40 cd% 39
April 20/12 Switched to Viramune + Truvada
Aug 2/12 cd4 1040, vl <40, cd% 38
Oct 19 cd4 1,110 vl <40 cd% 41

Offline tommy246

  • Standard
  • Member
  • Posts: 435
Re: When to Push for Meds?
« Reply #26 on: November 03, 2009, 03:39:03 AM »
Go read the johns hopkins hiv guide website its fantastic you can put your question to the respected dr gallant he will answer in three days or read the questions already asked in the starting treatment thread, it will make your decision easy. Also remember 14 % =200cd4 even though most docs use the cd4 as the main guide,my numbers are the same as yours i start atripla tonight and am happy to do so as in august i was in hospital for 3 weeks with pnuemonia with your numbers.
jan 06 neg
dec 08 pos cd4 505 ,16%, 1,500vl
april 09 cd4 635 ,16%,60,000
july 09 ,cd4 545,17%,80,000
aug 09,hosptal 18days pneumonia cd190,225,000,15%
1 week later cd4 415 20%
nov 09 cd4 591 ,vl 59,000,14%,started atripla
dec 09  cd4 787, vl 266, 16%
march 2010  cd4 720 vl non detectable -20  20%
june 2010  cd4  680, 21%, ND

 


Terms of Membership for these forums
 

© 2014 Smart + Strong. All Rights Reserved.   terms of use and your privacy
Smart + Strong® is a registered trademark of CDM Publishing, LLC.