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Author Topic: Isentress Question  (Read 2439 times)

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Offline egello

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Isentress Question
« on: March 26, 2010, 03:59:35 AM »
Hello Everyone

Lots of new people on here since last time I checked in.

Well, I have been on Norvir, Turvada and Reyataz combo since 2006 and been doing really well. My viral load undetectable and CD4 count in the normal range. My only complaint is that my face has been getting skinnier, and I can feel and see the loss of subcutaneous fat on my face. I don't know if thats due to too much working out, too much studying and not enough sleep or what not, but I do think it has partially to do with the PI regime.

So I was wondering about Isentress or other possible meds. It seems and sounds like the least toxic meds out there so far considering that it only targets integrase which is very specific to retroviruses and do not mess with other enzymes that may or may not have other natural bodily functions. I guess in that sense, NNRTI can also work too since it targets reverse transcriptase which is only applicable to HIV viruses.

My questions are:

1) Is Isentress only for treatment experienced patients that are resistant to one or more other types of drugs?

2) If I start Isentress, would it be harful in the long terms in that if I become resistant to it, I won't have much of other options? ( I am currently resistant to none )

3) What would be ( if anyone can think of any ) cons and pros of going off of my reyataz combo and starting Isentress combo with truvada? ( besides the fact that I can save money on ed drugs :) )

Thanks, any detailed help will be appreciated.


Reyataz / Norvir / Truvada/ Androgel 5 g / 2 days
1/29/07 14 T, 300 k V, 1.8 %
2/22/07 197 T, 247 V, 6.8 %
3/27/07 164 T, <50 V, 5.4 %
5/28/07 177 T, <50 V, 8.2 %
7/28/07 214 T, <50 V, 9.6 %
10/3/07 380 T, <50 V, 10 % no more Mepron, Famvir

Offline Assurbanipal

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  • Taking a forums break, still see PM's
Re: Isentress Question
« Reply #1 on: March 26, 2010, 10:28:36 AM »
Hi

Isentress is approved for everybody now.  It does have a relatively low barrier to resistance, so you need to be adherent.  But there is a second generation integrase inhibitor in the works and lots of other drug classes.

So, wouldn't hurt to talk to your doctor about whether it would work as well for you.

Regards
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%

Online Miss Philicia

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Re: Isentress Question
« Reply #2 on: March 26, 2010, 10:33:16 AM »
egello, what does your doctor say about you lipo self-diagnosis?  Does he agree or disagree?  What about a partner/boyfriend and/or very close friends?
"Iíve slept with enough men to know that Iím not gay"

Offline egello

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  • cb
Re: Isentress Question
« Reply #3 on: March 26, 2010, 11:16:37 AM »
Thanks for the info, regarding the self lipo diagnosis, no one has said anything about it. I mean its not one of those things that people go around commenting on, you know? however, I am almost certain that if my mother saw me ( she hasn't seen me for 4 years ) she will definitely say that my face looks very skinny. I can definitely see the edges around my cheek bone and shadowsunder them which I wasn't able to before. It is not horrifyingly disfuring, but i guess you can say from 1 to 10, 10 being worst, its around 3.

I haven't talk to my doctor about this yet, I have an appointment next month, and I wanted to go in prepared since he is always in a rush to get me out.

Also, I am kinda annoyed by the constant bloated look.

Anyways, are you whom used to be Philly?
« Last Edit: March 26, 2010, 11:29:56 AM by egello »
Reyataz / Norvir / Truvada/ Androgel 5 g / 2 days
1/29/07 14 T, 300 k V, 1.8 %
2/22/07 197 T, 247 V, 6.8 %
3/27/07 164 T, <50 V, 5.4 %
5/28/07 177 T, <50 V, 8.2 %
7/28/07 214 T, <50 V, 9.6 %
10/3/07 380 T, <50 V, 10 % no more Mepron, Famvir

Offline aztecan

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  • Posts: 5,398
  • 29 years positive, 57 years a pain in the butt
Re: Isentress Question
« Reply #4 on: March 26, 2010, 02:02:50 PM »
Hey Eg,

Good to see you again. I take Isentress and Truvada and have found it very easy to live with. No major problems, although this combo may be causing some ongoing dizziness I experience.

Regarding the lipo, Reyataz is the most forgiving of all the PIs when it comes to lipo, but it could be possible.

Keep in mind that living with HIV long term can also cause this. So, can age, stress or poor nutrition.
Are you seeing it elsewhere? I have never heard of lipoatrophy hitting just the face. Usually, it will also cause skinny legs or arms, or both.

I have both, but they are not as prounounced as they once were. That is something else to keep in mind. The situation may not reverse itself even if you do change meds.

That is just an FYI of which you were probably already aware.

I would definitely talk to your doc about it.

HUGS,

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

Offline egello

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  • Posts: 899
  • cb
Re: Isentress Question
« Reply #5 on: March 26, 2010, 02:13:45 PM »
Thanks Mark

Well, yes, I did notice it on my feet and hands as well as well as ankle area, again about 3 out of 10. However, I have thick muscular legs, so they don't look any skinnier but looks more "ripped"

Regarding the upper stomach region bloated look, I do remember when I was on viramune for a month or two, I didn't get that, but my stomach was as flat as it used to be.

I am thinking in terms of mechanically, that isentress might be a better option since its specific to HIV virus whereas say PI could interfere with other celluar functions. Anyone disagree on this?

Thanks
Reyataz / Norvir / Truvada/ Androgel 5 g / 2 days
1/29/07 14 T, 300 k V, 1.8 %
2/22/07 197 T, 247 V, 6.8 %
3/27/07 164 T, <50 V, 5.4 %
5/28/07 177 T, <50 V, 8.2 %
7/28/07 214 T, <50 V, 9.6 %
10/3/07 380 T, <50 V, 10 % no more Mepron, Famvir

Offline ATorrez

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  • Posts: 59
Re: Isentress Question
« Reply #6 on: March 26, 2010, 02:22:26 PM »
Truvada and Reyataz are not completely without lipid effects.

In the trials that came out recently they showed that up to 17% had mild to moderate and about 6% had moderatre to severe. If you look at any PI (Prescribing Information) for any other medication, other than HIV meds, 5+% makes it a COMMON side effect. Somehow, when Reyataz/Sustiva/Truvada/Epzicom cause it in 6-17% it is not a common side effect but a "rare" one.
Piss off a democrat: Take responsibility for your life and your actions.

"When Marxist dictators shoot their way into power in Central America, the San Francisco Democrats don't blame the guerrillas and their Soviet allies. They blame United States policies of 100 years ago. But then they always blame America first." -Jeanne Kirkpatrick

Offline egello

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  • cb
Re: Isentress Question
« Reply #7 on: March 26, 2010, 02:26:56 PM »
so this study was done on combination of Reyataz/Sustiva/Truvada/Epzicom or just one of each?

was this study done on say viramune or isentress?
Reyataz / Norvir / Truvada/ Androgel 5 g / 2 days
1/29/07 14 T, 300 k V, 1.8 %
2/22/07 197 T, 247 V, 6.8 %
3/27/07 164 T, <50 V, 5.4 %
5/28/07 177 T, <50 V, 8.2 %
7/28/07 214 T, <50 V, 9.6 %
10/3/07 380 T, <50 V, 10 % no more Mepron, Famvir

Offline ATorrez

  • Member
  • Posts: 59
Re: Isentress Question
« Reply #8 on: March 26, 2010, 02:38:33 PM »
http://www.poz.com/articles/hiv_bone_lipoatrophy_761_18049.shtml


According to AIDSMEDS 14-16% saw a 10% loss in fat. However, for some reason they say that Truvada/Reyataz/Epizicom/Truvada are "not associated" with it.

If you look at ANY other drug, ANY OTHER DRUG, a side effect that occurs more than 5% of the time is considered a common side effect. Apparently, they say that 40% is the cutoff for noticeability, but I don't know if I agree with that. And there was about 6% of the people who did have a clinically significant lipoatrophy, however, somehow HIV meds are held to a different standard than other medicatons.
Piss off a democrat: Take responsibility for your life and your actions.

"When Marxist dictators shoot their way into power in Central America, the San Francisco Democrats don't blame the guerrillas and their Soviet allies. They blame United States policies of 100 years ago. But then they always blame America first." -Jeanne Kirkpatrick

Offline Inchlingblue

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Re: Isentress Question
« Reply #9 on: March 26, 2010, 06:35:04 PM »
I was reading an article about integrase inhibitors in which Dr. Daniel Berger said:

there is no human homologue or enzyme counterpart of HIV integrase that exists within human cells, so integrase inhibitors are not expected to have toxicities to human cells.

I'm not sure how accurate that is since there is also no human homologue or enzyme counterpart of reverse transcriptase and the early NRTIs were pretty toxic but I thought it was a compelling statement nontheless.

I'm on Isentress/Truvada and doing great although at some point I'm hoping something better than Truvada comes along, for now it's fine.

LINK:

http://www.positivelyaware.com/forum/index.php?showtopic=79
« Last Edit: March 26, 2010, 06:48:42 PM by Inchlingblue »

Offline egello

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  • Posts: 899
  • cb
Re: Isentress Question
« Reply #10 on: March 26, 2010, 08:23:56 PM »
yeah, i totally agree, how can the nukes be toxic? what about a combo where its viramune, isentress and one of the drug in truvada?

That's three different class of drugs. Since there are some known side effects of truvada, by taking only one of its component, the side effect can be lessened.....

Is there any combo like that?
Reyataz / Norvir / Truvada/ Androgel 5 g / 2 days
1/29/07 14 T, 300 k V, 1.8 %
2/22/07 197 T, 247 V, 6.8 %
3/27/07 164 T, <50 V, 5.4 %
5/28/07 177 T, <50 V, 8.2 %
7/28/07 214 T, <50 V, 9.6 %
10/3/07 380 T, <50 V, 10 % no more Mepron, Famvir

Offline Assurbanipal

  • Member
  • Posts: 2,173
  • Taking a forums break, still see PM's
Re: Isentress Question
« Reply #11 on: March 26, 2010, 08:32:51 PM »
yeah, i totally agree, how can the nukes be toxic? ...

Tried to answer this in your other thread.  The nukes are "bad" nucleotides so it is possible they can get picked up in other cell functions where nucleotides are needed.

One of the nice things about the integrase inhibitors from that video is that they seem targetd to a larger (and thus less commonly used perhaps) cell structure.  The less basic the mechanism is that the drug screws up the less likely it is that the function will get screwed up for other purposes (if that makes any sense)
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 egello

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  • Posts: 899
  • cb
Re: Isentress Question
« Reply #12 on: March 26, 2010, 08:40:54 PM »
ahh,, so thats what you were trying to say...  ;D

so NRTI s are just bunch of nucleotides that will bind with HIV RNA? but how can that be, there are only 4 different kinds of nucleotides and the 3 out of those 4 are shared with DNA, so wouldn't the Nucelotides from NRTI be incorporated into the normal DNA replication function?

but what are you trying to say in your second paragraph? :P
« Last Edit: March 26, 2010, 08:43:51 PM by egello »
Reyataz / Norvir / Truvada/ Androgel 5 g / 2 days
1/29/07 14 T, 300 k V, 1.8 %
2/22/07 197 T, 247 V, 6.8 %
3/27/07 164 T, <50 V, 5.4 %
5/28/07 177 T, <50 V, 8.2 %
7/28/07 214 T, <50 V, 9.6 %
10/3/07 380 T, <50 V, 10 % no more Mepron, Famvir

Offline Assurbanipal

  • Member
  • Posts: 2,173
  • Taking a forums break, still see PM's
Re: Isentress Question
« Reply #13 on: March 27, 2010, 10:07:33 AM »


but what are you trying to say in your second paragraph? :P

The more complex the structure, the more likely it has only a single use.  And hence the risk that disabling it will have unanticipated bad side effects.
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 egello

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  • Posts: 899
  • cb
Re: Isentress Question
« Reply #14 on: March 27, 2010, 01:20:42 PM »
so anyone else have any comments about isentress before i go see my doctor about swithching the med?
Reyataz / Norvir / Truvada/ Androgel 5 g / 2 days
1/29/07 14 T, 300 k V, 1.8 %
2/22/07 197 T, 247 V, 6.8 %
3/27/07 164 T, <50 V, 5.4 %
5/28/07 177 T, <50 V, 8.2 %
7/28/07 214 T, <50 V, 9.6 %
10/3/07 380 T, <50 V, 10 % no more Mepron, Famvir

Offline mecch

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  • red pill? or blue pill?
Re: Isentress Question
« Reply #15 on: March 27, 2010, 02:07:08 PM »
How old are you.
I am a teacher and have obseved thousands of faces over the years, and my own.
If you are working out and quite thin, and if you are a very busy person, this shows on the face in the 20's, 30's.  You loose your healthy glow. May have nothing to do with HIV nor HAART.
18-25 year old faces are one thing.  25-35 yo faces another. 
In some european capitals the gay guys are quite thin, coffee drinking, cigarette smoking, gym goers.  You would swear so many 35-50 yos have lipo, you see all these sunken faces, but most often just the lifestyle and age.

If you want a jolly face, get married, stay home, eat well, rest, be happy and accept your aging body. 

Sorry if I went off topic.  I know HAART causes lipo in some people, so i'd ask experts to evaluate your face.
ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

Offline Etay1207

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  • Posts: 131
Re: Isentress Question
« Reply #16 on: March 27, 2010, 09:07:31 PM »
My partner takes levocarnitine. It has helped him alot.
POZ since 1999
1/07 tcells: 530 vl: 72,922 7/07 tcells: 542 vl: 26,577
9/08 tcells: 339 vl: 56,120  7/09 tcells: 267 vl: 663,160
11/09 tcells: 71 vl: 498,670 2/10 tcells: 52 vl: 322,000
 no meds and feeling great!

Offline Inchlingblue

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Re: Isentress Question
« Reply #17 on: March 27, 2010, 10:34:53 PM »
so anyone else have any comments about isentress before i go see my doctor about swithching the med?

There have been many threads about Isentress; you can always do a search and read through them if you want to be thorough about it.

 


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