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Starting Meds

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magnoman:
So my partner is starting meds this week and annoyingly I am not going to be here.  I am slightly confused as to what his initial meds are going to be, he mentioned some to me, although I hadn't heard of them. There again maybe the Spanish name is different.

He did tell me that he would have to take them twice a day and that it was essential that he took  them at exactly the same time each day, which slightly surprised me as I had understood there to be more flexibility in timings than that. He was also told that he could never drink alcohol whilst on the meds as it would have an impact on his kidneys or liver, which I think he found rather hard to take... not that either of us are heavy drinkers, although he does like to have a few when he goes out.

We are in South America, so I slightly worry that he is being given much older medication and less advanced than in the US or the UK... but I guess I am just worrying needlessly until I actually know what he is being given.

Anyway any advice you think I should give him? He is pretty depressed because here you start meds when your cd4 count is below 250 and he thought that he would have a few years as he was initially diagnosed after ARS last March and his CD4 dropped from 420 or so to 247 between the last two tests... and also here he tells me that it is officially medically called AIDS once you start treatment.....

Although I have told him that the term AIDS isn't really used anymore... but if it was to be AIDS he would have to either have an opportunistic infection or CD4 below 200.

Will report back once I know the exact meds regimen.

magnoman:
Ok this is what he told me he was taking... I believe these are all generic names which is why I hadn't heard of them.
1)Zidovudina
2)Lamivudina ...Duovir 1tab /12 h 8am.8pm

Zidoviduna is I believe AZT so it looks as though I was right about them using old medication.  Not totally sure about Lamivudina.

3) Efavirens .... 1tab /24h...8pm

Efavirens is I believe sustiva

I suspect whilst these are definitely better than nothing they aren't the most ideal initial combination. However I am very much aware that a little  knowledge is a dangerous thing.

If anyone can shed more light on this for me I would be grateful.

Miss Philicia:
For the US that is a combination of Combivir (tablet containing the two drugs lamivudine and zidovudine aka epivir and AZT) plus Sustiva (efavirenz).

As far as your other questions, one need not time taking things down to a precise minute of every day, but aiming for the general time makes adherence easier. Similarly with alcohol -- drinking too much means harder work on one's kidney and liver, but it's not going to hurt to go out to dinner and have a glass or two of wine on Saturday.

magnoman:
Thanks.  So combivir and sustiva doesn't sound too bad, although it does look as though meds have advanced a bit since it first came out. 

I appreciate that I probably sound a bit ungrateful that he isn't getting the latest medication especially as I doubt we could afford to pay for any medication and when I first heard of hiv there was no treatment at all.

Still I had got the impression that truvada is currently the best option and I had hoped he would have started with that.

If anyone else out there is taking this or has taken this would love to hear what your additional supplement regime was and whether you have any advice.

 I am going to be in the usa for the next  week and suspect that they're are better supplements available there.

mecch:
What do you mean by supplements?  HIV+ people do not necessarily need any special supplements...  Some supplementation is counterproductive if its going to tax the liver or kidneys. Or interact with the HAART. 

The treatment is HAART.  Other than that there are concerns for some people about brittle bones, cholesterol, etc etc.

Ideally the treating doc should be monitoring the HIV+ person to see what if any additional medicine or "supplements" are needed from an established scientific standpoint.

There is nothing "new" about truvada, which yeah, lots of people take because its very effective.  But not new.  I take truvada with one of the newer drugs - Isentress.  Must admit its been great.

Truvada + sustiva = Atripla. Atripla has already been around quite awhile, and the two components in it have been around longer.  :D

Maybe if you are really curious about all the combos available in your country you could search for the information from service organisations, the doctor, or websites in your country.  Its reasonable to be curious and concerned about access to the best meds and I would say it would be helpful if you had full information about what is and isn't available and under what conditions.

Timing is pretty important during the first months of HAART but as Miss P says not down to the precise minute...  When someone is reliably undetectable for awhile, I have heard of doctors being ok, with certain HAART combinations, of pretty damn flexible dosing times. 

Getting used to HAART can shock some peoples systems.  So moderation for alcohol for the moment is wise enough.  But again this is individual - how one person is dealing with the mix of a particular HAART combo and alcohol.

An order to stop drinking completely doesn't seem to be medically justified in many cases.  But we don't know the particulars of your friend.

You are really on the ball. Yep, its only an AIDS diagnosis if there are opportunistic illnesses + certain CD4 level.  Yep, the AIDS diagnosis means something different these days.  Your friend will in all likelihood repair his immune system and reach the new normal of living well enough with a chronic "condition". 

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