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Author Topic: New Regimen/New Numbers = Bummed  (Read 1712 times)

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Offline WildcatCC

  • Member
  • Posts: 91
New Regimen/New Numbers = Bummed
« on: May 07, 2010, 06:30:24 PM »
So the switch from Atripla to Isentress/Truvada has not been as successful as I thought. My numbers went in the opposite direction  :-[ .

The switch was predicated upon a discussion with my ID doc who wants me at undetectable (as do I!) and believed that Atripla was not doing it. No real resistance issues.

Am I expecting too much, too quickly? Patience is not a strong suit of mine.
Apr  08 - Diagnosed
Apr  08  cd4 8, vl 150k
Meds: Prezista/Norvir/Truvada
June 08 cd4 250, vl 1600
Aug  08 cd4 275, vl 450
Meds: Atripla
Nov  08  cd4  386, vl 255
Jan   09  cd4  415, vl 2100 (spike?)
Feb   09  cd4 460, vl 212
May   09  cd4 515, vl 1200
Aug   09  cd4 717, vl 1535 % 23
Sept  09  cd4 535  vl 1710 % 18
Oct   09  genotype shows mutation. Discussing w/ ID Doc
Nov  09   cd4 480  vl 650   % 19
Dec  09 genotype slight mutation to Epivir and Retrovir
Jan 10   cd4 508 vl 250 (21%)  low vitamin d - on supplement 2000 iu/day
Mar 15 Change to Isentress and Truvada
May 5 cd4 498 vl 1485
June 16 cd4 550 vl undect!!!! (finally dammit)

Offline WillyWump

  • Member
  • Posts: 7,277
Re: New Regimen/New Numbers = Bummed
« Reply #1 on: May 07, 2010, 08:45:55 PM »
I'm curious as to why you switched from Prez/Nor/Tru to Atripla back in '08?

-Will
POZ since '08

Last Labs-
11-6-14 CD4- 871, UD
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 bocker3

  • Member
  • Posts: 3,458
  • You gotta enjoy life......
Re: New Regimen/New Numbers = Bummed
« Reply #2 on: May 08, 2010, 07:53:16 AM »
If you haven't done this yet, please do so before switching regimens again:

Ask your doctor to have your VL tested using the branched-DNA test.  Most folks now utilize the HIV-PCR quant test.  That test is more sensitive (b-DNA only goes down to 75), but it is also more susceptible to "handling issues".  I went a year without hitting UD, although everything else seemed to be good -- when I did the b-DNA test -- boom -- UD.  I've since switched labs and have been UD even with the PCR test, but I firmly believe that something was happening with my samples at the other drawing site and/or lab.

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 mecch

  • Member
  • Posts: 12,166
  • red pill? or blue pill?
Re: New Regimen/New Numbers = Bummed
« Reply #3 on: May 08, 2010, 08:14:06 AM »
Gee those are frustrating results
Maybe change doctors, or testing methods.
What about adherence, are you 99%?
Absorption of meds issue?
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Assurbanipal

  • Member
  • Posts: 2,173
  • Taking a forums break, still see PM's
Re: New Regimen/New Numbers = Bummed
« Reply #4 on: May 08, 2010, 08:32:23 AM »
Basically you've been on Truvada the whole time and cycled from Prezista to Sustiva to Isentress?

That seems an odd pattern, given the relative resistance to mutation and viral suppression of the drugs.  Isn't that going from stronger to weaker?  Not to mention only swapping out one drug...

After two years perhaps it is time to seek a second medical opinion.
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 WildcatCC

  • Member
  • Posts: 91
Re: New Regimen/New Numbers = Bummed
« Reply #5 on: May 09, 2010, 07:59:01 AM »
Thanks for the replies.

I've never once missed my meds - no matter the regimen. It's funny, when I've had my blips, the doc office calls me and accuses me of not taking my meds. I really hate that but also know this is the number 1 reason usually for such swings in results. I've always taken my meds exactly as prescribed, when I'm supposed to and with/without food as indicated.

I think you are all right. I've placed a lot of trust in this doc - mostly out of loyalty as she saw me through my darkest times and iis the head of the ID department of my employer known for top notch HIV care.

She and I decided to wean off Pres/Nor/Truv as we believed it served its original purpose bringing down/up my initial ghastly numbers. The allure of Atripla - one pill a day showing "miraculous" results and info from my HIV support group and friends helped me make the decision to switch. Then months of just being marginally detectable and a few blips. The consideration to switch again was driven by my desire to be undetectable, once and for all (or at least as long as I could be).

I'll be seeking a second opinion.

Apr  08 - Diagnosed
Apr  08  cd4 8, vl 150k
Meds: Prezista/Norvir/Truvada
June 08 cd4 250, vl 1600
Aug  08 cd4 275, vl 450
Meds: Atripla
Nov  08  cd4  386, vl 255
Jan   09  cd4  415, vl 2100 (spike?)
Feb   09  cd4 460, vl 212
May   09  cd4 515, vl 1200
Aug   09  cd4 717, vl 1535 % 23
Sept  09  cd4 535  vl 1710 % 18
Oct   09  genotype shows mutation. Discussing w/ ID Doc
Nov  09   cd4 480  vl 650   % 19
Dec  09 genotype slight mutation to Epivir and Retrovir
Jan 10   cd4 508 vl 250 (21%)  low vitamin d - on supplement 2000 iu/day
Mar 15 Change to Isentress and Truvada
May 5 cd4 498 vl 1485
June 16 cd4 550 vl undect!!!! (finally dammit)

 


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