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Author Topic: What should I take first? Lab data included.  (Read 1170 times)

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Offline survivor703

  • Member
  • Posts: 56
What should I take first? Lab data included.
« on: March 22, 2012, 11:58:56 AM »
Hello guys, my name is Dwayne and Iím new here. I was recently diagnosed back in February of this year, around Valentine ís Day.  Itís been rough, but thanks to you all and the grace of God, Iím feeling much better. My CD4 is 502 (21%), and my viral load is 69K. Iím looking at going on a first line regimen pretty soon. I guess I want to know which first line regimen do you guys think is most effective (ignoring side effects).

My specialist has ran some tests and I will post the results here. I tested negative for Hep C and Hep A, however antibodies were found for Hep B. The doc says Iím negative and have an immunity to Hep B now, but it still worries me a little bit since I know Hep B can complicate things, right? Is it possible that the Hep B is just dormant and waiting to come back when my t-cells get too low or something? 

But anyway, staying on point Ė IĎd like to know answers to the questions below: 

**And you don't have to answer ALL questions if you can't -- but any question you can speak on would be greatly GREATLY appreciated. For what its worth, I am otherwise healthy. No other conditions.

1.)   What is the absolute BEST first line regimen (based upon virologic and immunologic response --- not convenience (i.e., 1 pill/day) ).

2.)   When a person starts meds, whatís the average time that a 100% adherent person with good absorption switches to a second line (i.e., average time until first line drug failure)?

3.)   I know itís hard, if not impossible,  to estimate when one was infected based upon numbers, but Iíve been obsessed with trying to find out when I got infected. I tested negative back in 2002 but have JUST gotten tested again ten years later, positive result of course with VL @ 69K, cd4ís @ 502.

4.)   Should I wait until I get to 350 T cells so that I can extend the amount of time without medicine, which will in turn increase the length of time before I possibly develop resistance, which will also prolong my liver and kidney function?

5.)   Last, but certainly not least, am I being overly optimistic by thinking that I can live a full live with HIV? Should I not get the mortgage that I was preparing to do, or pursue my PhD in biochemistry as planned? I have a feeling that I will live into my 50ís or 60ís. (Iím 29 now). Thatís the number that I gave myself in my head after much research and calculations and looking at averages. And I have this image in my head of my last few years being very sick. I hope this is not the care. I would hope that with current treatments, that I won't have to go on to develop AIDS.

Any insight will be helpful guys. Thanks for reading my question. Iím thankful I found this site.

***********************************************************

SOME LAB RESULTS: There were many other tests, but I think these are the important ones.

CYTOMEGALOVIRUS IGG,SER,QN  >5.00

GLUCOSE-6-PHOSPHATE DEHYDROGENASE, QL = 5.5

CREATININE
My level: 1.0
Standard Range: 0.7-1.5
Unit: MG/DL

GLOMERULAR FILTRATION RATE
My level: >60
Standard Range: >60
Unit: mL/min/m

ALT
My Level: 27
Standard: 0-50

AST
My Level: 31
Standard: 9-53

AMYLASE
My Level: 55
Standard Range: 0-110

ALKALINE PHOSPHATASE
My Level: 36
Standard Range:35-129
REPORT

--------------TESTS-------------RESULTS--------UNITS--REF. RANGE---

HIV-1 GENOTYPING REPORT

HIV-1 DRUG RESISTANCE MUTATION ANALYSIS

Nucleoside Reverse Transcriptase Inhibitors
EPIVIR (lamivudine, 3TC) No Evidence of Resistance
EMTRIVA (emtricitabine, FTC) No Evidence of Resistance
RETROVIR (zidovudine, AZT) No Evidence of Resistance
VIDEX (didanosine, ddI) No Evidence of Resistance
ZERIT (stavudine, d4T) No Evidence of Resistance
ZIAGEN (abacavir, ABC) No Evidence of Resistance
VIREAD (tenofovir, TDF) No Evidence of Resistance

Non-Nucleoside Reverse Transcriptase Inhibitors
RESCRIPTOR (delavirdine, DLV) No Evidence of Resistance
SUSTIVA (efavirenz, EFV) No Evidence of Resistance
VIRAMUNE (nevirapine, NVP) No Evidence of Resistance
INTELENCE (etravirine, ETR) No Evidence of Resistance

Protease Inhibitors

AGENERASE (amprenavir, APV) No Evidence of Resistance
LEXIVA (fosamprenavir, FOS) No Evidence of Resistance
CRIXIVAN (indinavir, IDV) No Evidence of Resistance
FORTOVASE (saquinavir, SQV) No Evidence of Resistance
KALETRA (lopinavir+ritonavir, LPV) No Evidence of Resistance
VIRACEPT (nelfinavir, NFV) No Evidence of Resistance
REYATAZ (atazanavir, ATV) No Evidence of Resistance
APTIVUS (tipranavir, TPV) No Evidence of Resistance
PREZISTA (darunavir, DRV) No Evidence of Resistance

* At least one mutation shown has not been fully validated.
** At least one muation shown has not been clinically verified.
*** For at least one mutation, both notes above apply.

DRUG RESISTANCE MUTATIONS DETECTED:

Reverse Transcriptase Gene:

Protease Gene:

NOVEL MUTATIONS DETECTED:

Reverse Transcriptase Gene: K49R, I50V, R83K, E122K, D123E,
L214F, R277K, K281R, I293V, P294T, E297R, I329L, G333D

Protease Gene: V3I, K20R, M36I, S37N, I62V, L63T, I72T

HIV Subtype: B


« Last Edit: March 22, 2012, 12:07:14 PM by survivor703 »
02/14/2012 Diagnosed (Happy valentines day)
02/15/2012 CD4 502 21%, VL 69,134
04/10/2012 CD4 607 22%, VL 60,893
10/08/2012 CD4 615 15%, VL 155,981
03/01/2014 CD4 340 17%  VL 65,689

Online buginme2

  • Member
  • Posts: 2,747
  • Certified Life Coach
Re: What should I take first? Lab data included.
« Reply #1 on: March 22, 2012, 10:23:58 PM »
1.  All first line treatments have about the same efficacy rate. 

2.  Unknown, however, you could theoretically remain on the same regimen forever.  Treatment failures happen, but if you remain adherent they are pretty rare.  You don't have any resistance issues so even if you were to fail a treatment you have plenty of options. Mdont worry needlessly about this.

3.  You cannot tell by looking at your numbers.  Sorry, you just can't.

4.  My personal opinion is no.  Increasing amounts of research are pointing to starting treatment earlier rather than later.  Besides at a cd4 count of 502 you just about meet starting guidelines in the U.S.

5.  Yes you can live a full life.  Don't quit school and keep your mortgage plans.  When I tested positive I was in the midst of grad school.  If I had quit because of HIV I definitely would have regretted that.  Keep your plans.

Regarding your Hep B.  it's not going to flare up.  Sounds like you have immunity.  Discuss it with your doctor, if you haven't been vaccinated you need to be for hep a (and hep b if your doctor recommends, you may be fully immune already though).

"All I need are some tasty waves, a cool buzz, and I'm fine."

http://www.youtube.com/watch?v=6e0gcEC1TWE

Offline aztecan

  • Member
  • Posts: 5,358
  • 28 years positive, 56 years a pain in the butt
Re: What should I take first? Lab data included.
« Reply #2 on: March 24, 2012, 10:40:21 AM »
I agree.

Any of the first-line treatments, and, actually, any regimen, can be effective. The key is adherence. Your GART looks great, you can take any regimen.

As far as how long one can remain on a regimen, I was on the same regimen for 11 years before switching and, even then, I switched because of long-term side effects not because of resistance.

There is no way to know when you were infected by looking at your numbers.

No, the standard of care in the United States is to consider treatment when the CD4 drops below 500. I would certainly start sooner rather than later because research has shown the effect of HIV on the body is ongoing and possibly cumulative and having a lesser amount of virus in the system is preferred.

Yes, you may live a long and full life. Average life expectancy is 69, but, if you watch you health and take reasonably good care of yourself, it could certainly be longer. This includes living a healthier life now, not waiting until you are 50.

Regarding the Hep B, don't sweat it. I also tested positive for Hep B, but I don't have an active infection. That means I was exposed to Hep B, but that either I never developed the full disease or fought it off. Whatever the reason, I am now immune to Hep B, and so are you.

HUGS,

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

Offline eric48

  • Member
  • Posts: 1,010
  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Re: What should I take first? Lab data included.
« Reply #3 on: March 25, 2012, 06:19:44 PM »
Hi,

Life expectancy issues are mostly for late presenters and /or people not reponding to treatment. and since you have plenty of option and starting from CD4 500, you should be doing fine.

Years of life lost to HIV for any one who can maintain UD and CD4 > 500 is in fact in the order of magnitude of months rater than years . May be one year at max.

Average years of life lost due to smoking : 10 years

Helps you put things in perspective, I hope

Eric

Offline survivor703

  • Member
  • Posts: 56
Re: What should I take first? Lab data included.
« Reply #4 on: March 27, 2012, 10:35:47 AM »
Well, I just want to thank each of you for contributing to my post. I feel much better and optimistic about starting treatment. I think that Iíve chosen to go with Isentress + Truvada. I think Iíll start sometime this summer Ė AFTER my vacation, lolÖ Maybe a little sooner.

Also, Iíve seen on another post were deaths related to treatments is very uncommon (in spite of liver and kidney issues). This is very encouraging to me as I had my doubtsÖ I thought I would be ďpoisoning myselfĒ by taking these drugs, but I see that although there is a toxicity factor, being the healthy male that I am, I will be able to handle it. So I will keep you guys updatedÖ Thanks for the information.

If anyone has information to pertinent research about isentress + truvada, feel free to leave it here on the thread.
Be well
02/14/2012 Diagnosed (Happy valentines day)
02/15/2012 CD4 502 21%, VL 69,134
04/10/2012 CD4 607 22%, VL 60,893
10/08/2012 CD4 615 15%, VL 155,981
03/01/2014 CD4 340 17%  VL 65,689

Offline aztecan

  • Member
  • Posts: 5,358
  • 28 years positive, 56 years a pain in the butt
Re: What should I take first? Lab data included.
« Reply #5 on: March 27, 2012, 11:00:50 AM »
As it happens, I am now on Isentress/Truvada.

I can report it is probably the easiest regimen I have taken, even though the Isentress is twice a day.

The reason I say this is I experienced no side effects from it, or if I did, they were so light that I didn't really notice them.

It is a breeze to take - no food restrictions or fasting required.

There is a good write up on both of these meds here in the treatment section, so you might take a gander at that.

I hope you are as pleased with the regimen as I have been.

HUGS,

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

Offline hubsen

  • Member
  • Posts: 17
Re: What should I take first? Lab data included.
« Reply #6 on: March 29, 2012, 05:51:55 PM »
Hi,
I'd recommend to start as soon as possible. Out of my experience, it only gets better.
The virus has deffinatly effected my even though my CD4 were high.
I've started with Atripla in June last year and beside minor dizziness at first, I did not experience other side effects, only benefits.

In just a week into my treatment my energy returned and I felt almost as my old-self (pre-infection). The dizziness gradually disappeared along with my viral level.

Atripla works perfect for (once a day pill) and it is very convinant to administrate.

There is no reason to wait. I wish Iwould have started as soon as I found out my +status.

It will only get better. You'll see.

Good luck with your 1st treatment - take care.
28/08/10 Infected
09/10 Diagnosed positive
09/10 CD4 563 VL 1,1K
10/10 CD4 327 VL 0,37K
10/10 CD4 382 VL 0,13K
11/10 CD4 454 VL 0,28K
12/10 CD4 569 VL 0,068K
04/11 CD4 383 VL 68000
05/11 CD4 405 VL 94000
06/06/11 Started on Atripla
07/11 CD4 537 VL     870
09/11 CD4 682 VL       25
12/11 CD4 641 VL.      UD
03/12 CD4 799 VL.      UD
09/12 CD4 870 VL.      UD
10/12 CD4 812 VL.      UD
11/12 CD4 901 VL.      UD
12/12 CD4 1051 VL.     UD
03/13 CD4  707 VL.     UD
09/13 CD4 1022 VL.    UD

Online wolfter

  • Member
  • Posts: 4,034
Re: What should I take first? Lab data included.
« Reply #7 on: March 29, 2012, 06:23:49 PM »
I too am on Truvada and Intellence along with Isentress.  It has been by far the best regiment to date for me.  I've had no side affects.  Or perhaps I have but they are so mild compared to past regiments that I don't fret about them.

Take care and best wishes

Wolfie
Judging someone does not define them, it defines you. 

True peace is not merely the absence of war, it is the presence of justice.

 


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