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Author Topic: A trend I noticed with those taking Atripla...  (Read 6527 times)

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Offline wylidas

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A trend I noticed with those taking Atripla...
« on: August 06, 2012, 08:40:30 PM »
I have been positive since 2005, I started meds in 2007 when my CD dipped below 300.

I have noticed when going through the boards on here that those taking Atripla tend to have VERY high CD4 counts. 700-800+ often times. While those of us who can't tolerate Atripla and take other things tend to have lower CD4 counts.

I know it's not a competition, and the goal is UD viral load, but this is something that has always bothered me for years now. My CD4 count has never risen above 500, not one time.
Anyone know why this is? WHat is in the Atripla that makes the CD4 climb so high.

Obviously the higher the CD4, the better off you are fighting infections etc and are generally 'healthier.' DO I have that right?
Diagnosed + in 2006.
Atripla in 2006 (Bad dreams, nervous system reaction after a few weeks. Discontinued.)
Epzicom/Reyataz/Norvir October 2007 - February 2012 (anxiety and elevated BP primary s/x)
UD VL <30
CD4 - fluctuates between 250 - 500 with 25%+
Discontinued meds in February 2012 (due to adherence issues after detoxing from Ativan)
March 2012 - CD4 296, VL 120
4/22/2012 - Started Complera
5/1/2012 - Discontinued Complera, began monitored drug holiday
7/3/2012 - VL 55,000; CD4 211 - started Bactrim
8/5/2012 - Began Truvada + Isentress

Offline newt

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Re: A trend I noticed with those taking Atripla...
« Reply #1 on: August 06, 2012, 09:30:13 PM »
Quote
I have noticed when going through the boards on here that those taking Atripla tend to have VERY high CD4 counts. 700-800+ often times. While those of us who can't tolerate Atripla and take other things tend to have lower CD4 counts.

When the sample size is big enough, eg in a decent cohort study of 10s of 1,000s of people, the difference in CD4 gain between NNRTI combos like Atripla and others is not significant. Maybe it's just something you notice in the forums/among friends?

It does of course depend which combo you started when and after how much time being HIV+. There's a world of difference eg between Atripla vs Crixivan/AZT/3TC and Atripla vs newer drugs. And untreated HIV for a year or two vs untreated HIV for a decade. And HIV in 1994 vs HIV in 2004. People starting now (this century) tend to start at higher CD4 counts with better drugs. There's a whole history before then of shit drugs (albeit lifesaving) and people living with very low CD4 counts for a long time.

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

Offline joemutt

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Re: A trend I noticed with those taking Atripla...
« Reply #2 on: August 07, 2012, 12:57:20 AM »
as your evidence is anecdotal, i will add mine; 
generics of truvada plus viramune,
cd 4 between 1100 and 1500 at 48 to 50 %.

Offline wylidas

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Re: A trend I noticed with those taking Atripla...
« Reply #3 on: August 07, 2012, 12:28:35 PM »
Those are great numbers joemutt!
It's definitely not the norm from the trends I see on these boards, but that;s awesome!
Diagnosed + in 2006.
Atripla in 2006 (Bad dreams, nervous system reaction after a few weeks. Discontinued.)
Epzicom/Reyataz/Norvir October 2007 - February 2012 (anxiety and elevated BP primary s/x)
UD VL <30
CD4 - fluctuates between 250 - 500 with 25%+
Discontinued meds in February 2012 (due to adherence issues after detoxing from Ativan)
March 2012 - CD4 296, VL 120
4/22/2012 - Started Complera
5/1/2012 - Discontinued Complera, began monitored drug holiday
7/3/2012 - VL 55,000; CD4 211 - started Bactrim
8/5/2012 - Began Truvada + Isentress

Offline leatherman

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Re: A trend I noticed with those taking Atripla...
« Reply #4 on: August 07, 2012, 12:44:45 PM »
It's definitely not the norm from the trends I see on these boards
always remember 2 things about what you see on these boards:

1) it's a terribly SMALL sampling. It's usually people from America and with enough money for a PC and internet connection. Look at the member count over to the left. Subtract the people that don't post and subtract the AII? posters and the number is ever smaller.

2) As this is a support site, you're bound to get more people having problems and needing support, as those who are not having problems don't come here as often.

so this site has too small a sample skewed towards those with problems to ever think of what happens here as the "normal" data of "everyone with HIV/or on meds"
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline wylidas

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Re: A trend I noticed with those taking Atripla...
« Reply #5 on: August 07, 2012, 01:20:07 PM »
Good point, leatherman. I didn't look at it that way, but makes sense.
I just am very analytical (it's the nature of being an educator - grin) and I notice a lot of trends on these boards, and it does seem like Atripla folks have higher CD4s in general.

My own personal experience in the real world (off the boards) also seems to corroborate this, as many of my friends on Atripla have VERY high CD4 numbers, like 900+. Where as mine has languished around 400-500 for years, despite being very healthy active and eating an insanely healthy diet, all organic, and I drink 3-4 liters of water a day. Even my friends think it's strange that my CD4 never has climbed above 500 at 28%.

So, I don't know. Maybe I will finally break the 500 barrier with I+T combo. Because I never did with Epzicom/Reyataz/Norvir.

Diagnosed + in 2006.
Atripla in 2006 (Bad dreams, nervous system reaction after a few weeks. Discontinued.)
Epzicom/Reyataz/Norvir October 2007 - February 2012 (anxiety and elevated BP primary s/x)
UD VL <30
CD4 - fluctuates between 250 - 500 with 25%+
Discontinued meds in February 2012 (due to adherence issues after detoxing from Ativan)
March 2012 - CD4 296, VL 120
4/22/2012 - Started Complera
5/1/2012 - Discontinued Complera, began monitored drug holiday
7/3/2012 - VL 55,000; CD4 211 - started Bactrim
8/5/2012 - Began Truvada + Isentress

Offline leatherman

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Re: A trend I noticed with those taking Atripla...
« Reply #6 on: August 07, 2012, 07:34:11 PM »
Where as mine has languished around 400-500 for years, despite being very healthy active and eating an insanely healthy diet, all organic, and I drink 3-4 liters of water a day. Even my friends think it's strange that my CD4 never has climbed above 500 at 28%.
a few more thoughts for you to think about:

1) how low did your cd4 nadir reach? studies have shown that many who hit very low nadir have a very long recovery and often do not increase much as time goes by.

for example, I had cd4 counts over half a year reaching 12, 9, 7, and 5. It then took over 12 yrs (with medications) before my cd4s climbed and stayed over 200. Now after 20 yrs of meds, I reached my all-time high of 318 (16%) just this past year. Many studies have shown that people whose immune systems were as comprised as mine have had this same kind of slow, and low recovery.

2) all those things you listed really have little to do with cd4 recovery. basically keeping HIV in check, allows your immune system to recover. While those other things may make you healthier they don't really improve your immune system. There is really not much of anything that increases cd4s, although they are working on drugs that may help.

3) like many people, you probably never had a pre-HIV cd4 count taken. Since 400-1500 is the "healthy" range, you might never have had a cd4 of over 500 before HIV, so of course, you may never reach something high like 900

4) high cd4 count means nothing. what means everything is whether your immune system does the job it's supposed to. my "bad" count average of 175 (0ver the last 10 yrs) and 14% ratio has resulted in me NOT being back in the hospital in over 15 yrs, while having no flu, 1 cold, and 2 fevers. While having a number like 600 would make me feel emotionally happier, my low cd4 is keeping me quite well and I have no complaints about it.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline eric48

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Re: A trend I noticed with those taking Atripla...
« Reply #7 on: August 09, 2012, 06:20:50 PM »
Hi,

A recent article which I have started commenting here:

http://forums.poz.com/index.php?topic=33062.msg541592#msg541592

shows that in a large cohort of asymptomatic HAART initiators the difference in CD4 between EFV users and NVP users is ... 10 !

Quite far from what you think you are seeing...

This question is debated over and over in clinical trial and cohorts follow ups. While most recent drugs are not always including (obviously) in large, long timer cohorts, those studies have never shown any significant difference in CD4 recovery.

I have a post under preparation that discusses the difference of ... 10.

It takes a bit of time to try to make a complex issue easy to grasp.

One thing most people forget: HAART (even if the patient is UD) does not Suppress the virus. It hinders its replication.

If you are under a modern NNRTI + NRTI regimen, once a virion penetrates, its first retrocopy is jammed by the meds. While the meds are efficient, they are not 100 % efficient and some Virus RNA/DNA can be successful in their entry into chromosome DNA. BUT in such a small extend that the infected cells is not signaled to killing by immune system or apoptosis (self destruction) . These slightly infected cells are efficient (in terms of their basic immune functions), so it is not so much of a problem for the patient. In some patients these cells are better/earlier signalled, and eliminated. hence a lower steady state CD4 count

This is pretty much due to various factors such as genetics.

Clinical trials that have attempted to resolve the issue of those portion of patients that are UD for a while, but have a less than optimal CD4 recovery, have all been disappointing.

One last thing, of importance IMHO, is the percentage.

Ideally what you would like is a well balanced system and not necessarily a high percentage of CD4 or/AND a high percentage of CD8: these cells are part of the 'acquired' immune defense and good at keeping in check a resident virus/Bacteria/fungus (such as herpes, candida,...) or a coming-back visitor (influenza). Over-expansion of the 'acquired' immune defense compartment is at the expense (in terms of percentage) of the other compartment: the innate immune systems (typically Natural Killer, they are named natural because they are not 'trained')
These are very important since they are at the same time not very efficient (not very lethal), but, also the only ones able to somehow fight unknown infections, especially those that are very difficult for the body to identify as non-self: cancerous cells.

So, on the long run, it is not so much the counts that count but the diversity.

A note on structured treatment interruption: some people do it and I belong to the group of people who might consider it at one time. yet, IMHO, this is only for people who can afford the luxury of losing a bit of their 'banked' CD4s and not so much for people whining about a lower CD4 bank account

Hope this helps

Eric
« Last Edit: August 09, 2012, 06:26:34 PM by eric48 »
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: NCT02157311 = 4d. ON, 3d. OFF)

Offline Miss Philicia

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Re: A trend I noticed with those taking Atripla...
« Reply #8 on: August 09, 2012, 07:08:21 PM »

4) high cd4 count means nothing.

Statistically that's incorrect. Personal anecdotes don't mean much.
"Iíve slept with enough men to know that Iím not gay"

Offline leatherman

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Re: A trend I noticed with those taking Atripla...
« Reply #9 on: August 09, 2012, 08:51:27 PM »
Statistically that's incorrect. Personal anecdotes don't mean much.
how so?

of course cd4 count is important, because we all need "some" cd4s. Science has also shown that having over 200 tends to make someone less prone to OIs. (Although people can remain healthy with less than 200). I used a bit of hyperbole to suggest, not that having a higher cd4 count meant nothing at all; but that having some arbitrarily high number (like 800-1000) did not mean anything because it doesn't mean that one is healthier.

without knowing someone's pre-HIV average cd4 there is no way to know what should be that person's "normal" cd4 count. someone with 500 (the lower end of the "normal" range) can have an immune system that functions just as well as someone with 1500 (the higher end of the range). That "high" cd4 counts does not make that person "healthier" than the person with the lower count.

btw, while anecdotes are not scientific fact, personal stories often make understanding a situation or fact easier.

I used my story (of being as well in a 200-300 range of cd4s as someone in a 500-700 range) to help explain how the "normal" range of cd4s stretches from approx 500-1500. The quality of the immune system is not solely based on the absolute number of cd4s but is also influenced by other genetics. A higher cd4 count does not mean a person is healthier than someone with a lower cd4 count.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Online buginme2

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Re: A trend I noticed with those taking Atripla...
« Reply #10 on: August 09, 2012, 09:01:49 PM »
how so?


Coincidental, this article was just published today.  The main point of the article is:

"Patients starting antiretroviral therapy in Africa had a much better chance of survival if their on-treatment CD4 count reached >500 cells/mm3."

Leatherman, I agree with you that the difference between a cd4 count of 500 versus one of 1000 is probably negligible.  There have been quite a few studies as of late that are showing those who are on treatment but do not reach the minimum number of 500 are faring less well than those that do reach 500.  The article I link to below hypothesizes that its better to start treatment earlier because waiting may limit the person from achieving 500 if they start with a lower cd4 count.

http://www.medscape.com/viewarticle/768024?src=nl_topic
Don't be fancy, just get dancey

Offline NY2011

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Re: A trend I noticed with those taking Atripla...
« Reply #11 on: August 09, 2012, 10:36:01 PM »
I've been keeping track of my lab reports here on this site, and I recently asked my doctor his opinion as to why my Cd4 is slightly higher than the average #'s I see listed here. My doctor simply said it probably comes down to genetics.

 When I first visited my doctor with a high fever and rash, I had been infected for 20 days, and the virus was overwhelming my immune system.  PCR results showed that my CD4 count during seroconversion was 156. He immediately started me on Prezista+Norvir+Truvada.  45 days later, my CD4 climbed to 750, but the Prezista wasn't being well tolerated by my liver.   So, I switched to sustive+Truvada(atripla).  Well, another 45 days later, my Cd4 shot up to 1221. Recent lab tests resulted in a Cd4 count of 1224 . 

Genetics may be playing a role, but I strongly feel that the combination of drugs in Atripla work extremely well, and that that along with starting very early, is what may be making the difference. 

Check out the VISCONTI trial, where 14 people were started on antivirals within 10 weeks of acute infection. They were able to stop ART after three years, and they  still maintain UD levels in their blood.

I don't think I would take that risk, but I have fantasized quite a bit about it.
« Last Edit: August 10, 2012, 02:42:07 PM by NY2011 »
10/26/2011 - SEROCONVERSION (hi fever+rash)
10/31/2011 - CD4= 154  VL>500,000 
10/31/2011 - started on Truvada+Prezista+Norvir
12/14/2011 - CD4= 750 VL=6412 (45%)
01/27/2012 - switched to Atripla
04/23/2012 - CD4=1,221 VL= 140  (47%)
06/22/2012 - CD4=1,224 VL= ud    (49%)
12/18/2012 - CD4=1,031 VL= ud    (51%)
09/16/2013 - CD4=1,151 VL= ud   ( 49%)
03/26/2014 - CD4=1,050 VL= ud
11/25/2014 - CD4=1,335 VL= ud

Offline friskyguy

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Re: A trend I noticed with those taking Atripla...
« Reply #12 on: August 09, 2012, 11:44:30 PM »
We all get so hung up on concentrating on CD4 counts and being UD in the blood.......sure its important but this is NOT the end of the story.........

i see most people in the forum ignore research about HIV viral replication in the CSF, ie brain for example. You can be UD in the blood and u think ur doing just fine but the virus can be still running amok replicating and causing long lasting and permanent damage to the brain.....just ask misha who has mentioned he had remained UD in the blood yet had the virus still active in the CSF.

Unfortunately this field of research is limited and I argue needs much more attention. There is another thread 'HIV in the brain' Research News and Studies  which he started that discusses this very important topic

And in regards to the VISCONTI trial I am not sure if they have tested for HIV in the CSF and other body compartments and/or in macrophages to see if these patients have truly suppressed the virus apart from the blood ......yes the clever HIV virus also infects other cells besides CD4s in the blood remember!!!!
Sero converted Sept '10 / Confirmed + Dec '10
Jan '11, VL 9,500 / CD4 482 (32%)
Feb '11, VL 5,800 / CD4 680 (37%)
start Atripla
Mch '11, VL UD / CD4 700 (42%)
Jun  '11, VL UD / CD4 750 (43%)
swap to Kivexa and Efav. due to osteopenia diag. (DEXA) / kidney issues ( decline in eGFR to 77 )
start supplements - Vit D3 / Omega 3 / multivitamin / mini aspirin
Dec '11,  VL UD <20 /  CD4 670 (49%)  / CD4:CD8 = 1.4
all labs now within normal ranges
Mch '12,  VL UD / CD4 600 (51%)
Sep '12,  VL UD / CD4 810 (51%)
Mch '13   VL UD / CD4 965 (56%)
Sep '13   VL UD / CD4 (not taken)
Dec '13   VL UD / CD4 901 (35%) / CD4:CD8 = 1.1  /  eGFR > 100

Offline Miss Philicia

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Re: A trend I noticed with those taking Atripla...
« Reply #13 on: August 10, 2012, 01:09:25 AM »
how so?

of course cd4 count is important, because we all need "some" cd4s. Science has also shown that having over 200 tends to make someone less prone to OIs. (Although people can remain healthy with less than 200). I used a bit of hyperbole to suggest, not that having a higher cd4 count meant nothing at all; but that having some arbitrarily high number (like 800-1000) did not mean anything because it doesn't mean that one is healthier.

without knowing someone's pre-HIV average cd4 there is no way to know what should be that person's "normal" cd4 count. someone with 500 (the lower end of the "normal" range) can have an immune system that functions just as well as someone with 1500 (the higher end of the range). That "high" cd4 counts does not make that person "healthier" than the person with the lower count.

btw, while anecdotes are not scientific fact, personal stories often make understanding a situation or fact easier.

I used my story (of being as well in a 200-300 range of cd4s as someone in a 500-700 range) to help explain how the "normal" range of cd4s stretches from approx 500-1500. The quality of the immune system is not solely based on the absolute number of cd4s but is also influenced by other genetics. A higher cd4 count does not mean a person is healthier than someone with a lower cd4 count.

Figures you'd blather on endlessly about your erroneous statement.

CD4 cell count below 500 increases cancer risk for patients with HIV
"Iíve slept with enough men to know that Iím not gay"

Offline leatherman

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Re: A trend I noticed with those taking Atripla...
« Reply #14 on: August 10, 2012, 03:23:00 AM »
CD4 cell count below 500 increases cancer risk for patients with HIV
approx 2% or less were affected by cancers and many of those had "frequent virological failure", also there was some data about how many yrs below 200 cd4 and very low nadir would cause an increase in the risk.

while I don't dispute that having cd4 counts above 500 can be more beneficial, this study would seem to suggest that a person will have a greater chance to be adversely affected by long term side effects from the meds (usually in a 2-10% range) than cancer from low cd4s (<3%).  :o

it also seems to suggest there even with cd4s under 500 that there's a 97% chance of NOT having cancer. ;)
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline leatherman

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Re: A trend I noticed with those taking Atripla...
« Reply #15 on: August 10, 2012, 03:49:18 AM »
despite all the nitpicking on percentages of what might happen if a person's cd4s stay under 500, there are still two main problems that make this a useless debate

1) without knowing a person's pre-hiv cd4 there's no way of knowing how low a "normal" cd4 count would be for someone based on their genetics. None of these studies are able to say what the percentages of cancer or health are for a person who had a normal cd4 count of 500. As that would not be abnormally low for that person, would they still be predisposed to cancers, etc??

2) there's little one can do to raise their cd4 count. After viral suppression it becomes a game of genetics on how much a person's immune system will recover and how high cd4s may climb.

personally, as someone who had a very low nadir, took a long time to fully suppress the virus, and have been unable to obtain 500, I'm going to look on the bright side of things - that those factors don't necessarily mean cancers, other side effects or early death. I'm also always going to try to pass that optimism on to others who don't seem to be able to reach the vaunted levels of >500. I'm going to suggest that a person not stress too much on something that can't be changed anyway, and that they should live their lives without thinking they haven't done something right (as long as they stayed in successful therapy of course LOL)
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Miss Philicia

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Re: A trend I noticed with those taking Atripla...
« Reply #16 on: August 10, 2012, 08:30:18 AM »
Bivens, as usual you seem to not understand the discussion and are indulging in self-projection. Nobody says that it's a given for one particular person with a sub-500 count to get an array of nasty cancers. But statistically it's more possible, which is why I was insistent that your earlier comment was factually incorrect.

It's rather sad that you can't just say that you were wrong and move on.
"Iíve slept with enough men to know that Iím not gay"

Offline leatherman

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Re: A trend I noticed with those taking Atripla...
« Reply #17 on: August 10, 2012, 10:28:02 AM »
But statistically it's more possible, which is why I was insistent that your earlier comment was factually incorrect.
it's statistically possible to get HIV from oral sex or from using someone's toothbrush too; but we usually tell people not to be troubled about that kind of incredible possibility. it's statistically possible to have some terrible side effect from a med; but we usually tell people not to be troubled about those possibilities. it's statistically possible to get some cancer from not having your tcells gets over 500; but since there's nothing a person can do to get a cd4 count to increase, we usually tell people not to be troubled about those possibilities too. Why let someone be stressed about something they can't affect, especially since the stress actually can cause more harm.

Maybe you missed the part where I said that I was using hyperbole to discount the OP's concern about not having counts over 1000. So let me say it in a different way. While having a higher cd4 may make it statistically less possible for a person to have cancers or other other issues, since there is currently no magic shot, drug, or supplement to raise a person's cd4s up to a level >500, a higher cd4 count for many people, in reality, means nothing as it simply may be unattainable.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Rockin

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Re: A trend I noticed with those taking Atripla...
« Reply #18 on: August 10, 2012, 11:36:33 AM »
I do believe there are 3 things that explain one's response to said medicine:

1. Genetics
2. Viral Resistance (i.e. HIV strain)
3. Adherence

But yeah, genetics plays a huge part on everything. How else do you explain how someone can suffer nasty side effects from one medicine while others don't? There is no actual proof that Atripla is "better" than others, I think.
 

Offline Common_ground

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Re: A trend I noticed with those taking Atripla...
« Reply #19 on: August 10, 2012, 11:59:14 AM »
When we say "the virus affects us differently/its your virus" etc etc I think its a proof of how little we know both about the body and the HIV virus. I am sure there is more to it than CD4 counts and viral load (I think thats already concluded but not fully studied yet) and really hope we get a better grasp of what actually is happening with our bodies and HIV. How all these different interactions pan out and why they pan out with such diversity among people.

I would also like to add to the list: environment , diet, habits and maybe even mental strength.

Regarding side effects, well, many times I wonder if I am just lucky or just not so picky.
 
2011 May - Neg.
2012 June CD4:205, 16% VL:2676 Start Truvada/Stocrin
2012 July  CD4:234, 18% VL:88
2012 Sep  CD4:238, 17% VL:UD
2013 Feb  CD4:257, 24% VL:UD -viramune/truvada
2013 May CD4:276, 26% VL:UD

Offline NY2011

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  • Posts: 141
Re: A trend I noticed with those taking Atripla...
« Reply #20 on: August 11, 2012, 07:29:28 AM »
I agree w/ the last three posts. I was thinking that it was my attitude, or my determination, and my daily shot of wheatgrass and turmeric and all that crap, but my doctor pretty much said that while all of that is important, genetics and adherence are the two things that are probably keeping the Cd4 count high and viral load in the blood low.
So, I don't know any differently other than to do what I am doing.  What would be disconcerting is if the cd4 begins to drop even though I continue taking an active role in my health and well-being. I would have a hard time with that, because then the illusion of me having control of this would likely begin to wane.
« Last Edit: August 11, 2012, 10:22:51 AM by NY2011 »
10/26/2011 - SEROCONVERSION (hi fever+rash)
10/31/2011 - CD4= 154  VL>500,000 
10/31/2011 - started on Truvada+Prezista+Norvir
12/14/2011 - CD4= 750 VL=6412 (45%)
01/27/2012 - switched to Atripla
04/23/2012 - CD4=1,221 VL= 140  (47%)
06/22/2012 - CD4=1,224 VL= ud    (49%)
12/18/2012 - CD4=1,031 VL= ud    (51%)
09/16/2013 - CD4=1,151 VL= ud   ( 49%)
03/26/2014 - CD4=1,050 VL= ud
11/25/2014 - CD4=1,335 VL= ud

Offline wylidas

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  • Posts: 85
  • Trying to love this life, since it's all we got.
Re: A trend I noticed with those taking Atripla...
« Reply #21 on: August 11, 2012, 12:28:38 PM »
SInce I posted the OP, I wanted to clarify what I was getting at.

I just was noticing trends, and it does seem that people taking Atripla have higher CD4 counts. My doctor has never been worried that my highest CD4 was around 490, and it actually fluctuates between 300-490 with percentages around 28%. I remain UD when on treatment, and in fact the virus (before I stopped treatment in Spring) was <20 copies/mL. VERY UD as my doctor put it.

My point was to hash out what really causes CD4 to be higher or lower in people. Medical professionals can't even seem to agree, because the bottom line is we just don't know.

I was diagnosed + in 2005, and I got my first official labs drawn in 2006 and my CD4 was slightly over 500 at that time. I don't know when I sero-converted for sure, as I was living in NYC at the time and I was having a lot of unprotected sex, and even doing drugs, so I didn't care. My best guess is that I probably sero-converted in early 2004. Regardless, I agree with Leatherman in that we all may start at a different number CD4 depending on our genetics. My 'high' may be around 600 to start with, so expecting it go above 1,000 is probably pointless.

And I agree with the posts here saying there is not much we can do about it anyway. The only thing we can do is exercise and eat healthy and try and keep our stress levels low. There is no point in worrying about a 3% chance of Cancer risk when there is absolutely nothing we can do about it.

FOr me especially, even if Atripla was a sure-fire way to get my CD4 numbers up, I already know that I absolutely cannot tolerate its side effects, so it does no good for me to wish on a star. I'm just going to live my life and enjoy the time I have. And hopefully that will be enough (along with med adherence) to keep me around for a lot longer.

Diagnosed + in 2006.
Atripla in 2006 (Bad dreams, nervous system reaction after a few weeks. Discontinued.)
Epzicom/Reyataz/Norvir October 2007 - February 2012 (anxiety and elevated BP primary s/x)
UD VL <30
CD4 - fluctuates between 250 - 500 with 25%+
Discontinued meds in February 2012 (due to adherence issues after detoxing from Ativan)
March 2012 - CD4 296, VL 120
4/22/2012 - Started Complera
5/1/2012 - Discontinued Complera, began monitored drug holiday
7/3/2012 - VL 55,000; CD4 211 - started Bactrim
8/5/2012 - Began Truvada + Isentress

Offline Rockin

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  • Posts: 494
Re: A trend I noticed with those taking Atripla...
« Reply #22 on: August 12, 2012, 08:45:53 PM »
SInce I posted the OP, I wanted to clarify what I was getting at.

I just was noticing trends, and it does seem that people taking Atripla have higher CD4 counts. My doctor has never been worried that my highest CD4 was around 490, and it actually fluctuates between 300-490 with percentages around 28%. I remain UD when on treatment, and in fact the virus (before I stopped treatment in Spring) was <20 copies/mL. VERY UD as my doctor put it.

My point was to hash out what really causes CD4 to be higher or lower in people. Medical professionals can't even seem to agree, because the bottom line is we just don't know.

I was diagnosed + in 2005, and I got my first official labs drawn in 2006 and my CD4 was slightly over 500 at that time. I don't know when I sero-converted for sure, as I was living in NYC at the time and I was having a lot of unprotected sex, and even doing drugs, so I didn't care. My best guess is that I probably sero-converted in early 2004. Regardless, I agree with Leatherman in that we all may start at a different number CD4 depending on our genetics. My 'high' may be around 600 to start with, so expecting it go above 1,000 is probably pointless.

And I agree with the posts here saying there is not much we can do about it anyway. The only thing we can do is exercise and eat healthy and try and keep our stress levels low. There is no point in worrying about a 3% chance of Cancer risk when there is absolutely nothing we can do about it.

FOr me especially, even if Atripla was a sure-fire way to get my CD4 numbers up, I already know that I absolutely cannot tolerate its side effects, so it does no good for me to wish on a star. I'm just going to live my life and enjoy the time I have. And hopefully that will be enough (along with med adherence) to keep me around for a lot longer.

I think every human being should be concerned about health issues...we should all try to eat better and exercise, period. Regardless of HIV.

As for CD4, I try not to think about it. Mine is at 351 after a year to treatment. CD4 got to the lowest point of 260 when I was sick.

I think how we feel is actually a much bigger signal than amount of CD4. I have been feeling great health-wise so I don't really fret about CD4 fluctuation, as long as I remain UND.

Offline wylidas

  • Member
  • Posts: 85
  • Trying to love this life, since it's all we got.
Re: A trend I noticed with those taking Atripla...
« Reply #23 on: August 13, 2012, 11:31:28 AM »
Rockin- I am right there with you. When I was on my old regimen, my CD4 would fluctuate between 350-490, never rising above 500, but my VL was always UD and I felt pretty good most the time. Having energy and almost NEVER getting sick. In fact, I got sick less than other healthy negative people I knew. :)

And I think that goes a long way in keeping a positive outlook and staying healthy.
Diagnosed + in 2006.
Atripla in 2006 (Bad dreams, nervous system reaction after a few weeks. Discontinued.)
Epzicom/Reyataz/Norvir October 2007 - February 2012 (anxiety and elevated BP primary s/x)
UD VL <30
CD4 - fluctuates between 250 - 500 with 25%+
Discontinued meds in February 2012 (due to adherence issues after detoxing from Ativan)
March 2012 - CD4 296, VL 120
4/22/2012 - Started Complera
5/1/2012 - Discontinued Complera, began monitored drug holiday
7/3/2012 - VL 55,000; CD4 211 - started Bactrim
8/5/2012 - Began Truvada + Isentress

 


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