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Meds, Mind, Body & Benefits => Questions About Treatment & Side Effects => Topic started by: DaneGrey on May 31, 2006, 06:13:58 pm

Title: what about old threads & recently asked questions
Post by: DaneGrey on May 31, 2006, 06:13:58 pm
Will post from the old board be migrated to this new one?

If we have recently asked some questions should we re-ask?

curious
Title: Re: what about old threads & recently asked questions
Post by: DingoBoi on May 31, 2006, 06:19:59 pm
none of the old threads will be transferred to the new forums... if you wish to continue the discussion, please repost your questions again here.
Title: Re: what about old threads & recently asked questions
Post by: newt on May 31, 2006, 06:36:12 pm
The answer is no. Hence my tenofovir/abacavir thread...

While I appreciate the difficulties of moving the old forum to this one, it is not that hard to move individual pieces of content eg a whole thread or two.  Some stuff, esp. some slow-moving but important threads on T-20, lipodystrophy and one or two other topics will be lost, and the wealth of exp. shared there gone.

Me, I'm not for re-typing.  Saving yourself the 'for print' version of a thread from the other forum is handyway to keep info under these circumstances.

- matt

Title: Re: what about old threads & recently asked questions
Post by: Ann on May 31, 2006, 07:09:20 pm
Here's an experiment. I've taken a shortish thread from the Treatment Questions forum and clicked on the printer to get the raw text format. I then copied and pasted the whole thing here. If people find the method agreable, you could then take the threads you'd like to see carried on over here and bring them on over. You'd want to keep the original title.

What do you think? Here's the thread:

Topic Title Start or Not Start Meds w/Hep B



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Date Posted: Tuesday May 30, 2006 3:56 AM
Posted By: YnotinVA
I was diagnosed HIV + back in Nov. 2005 while admitted in the hospital for Acture Retinal Necrosis (shingles of the eyes/herpes related). Upon my first test results I was VL=undetectable, CD4=334. The doctor says my CD4 was low because my body was fighting off the virus I had in my eye. After being released from the hospital 4 days later and then having a follow up visit with the infectious disease doctor, I had labs run again. This time I was VL=17809, CD4=861. No treatment recommended at this time by the doctor. My next visit,3 months later, my labs showed VL=174,306, CD4=593. We decided to run the labs again about a month later and this time it was VL=86955, CD4=442. I wasn't confident and comfortable with my current ID doctor, so I transferred to a new one where he looked at my past lab results. I was also diagnosed with high amounts of syphllis and had to be on antibiotics for 10 days via IV. So he wanted to take care of this problem before proceeding with any treatment for HIV. I haven't yet had my new labs done since the antibiotic IV treatment for my syphllis or for my HIV numbers...but at my last visit he wanted to start me on treatment using Truvada and Sustiva. I was very apprehensive and he told me to think about it and to have new labs done in about a month and then follow up with him. I'm not opposed to starting treatment, I just not sure if it's necessary at this time (but I will definately want to start if my next labs are shown to go down).

I'd like to see what others have experienced with numbers approximately near mind and if anyone has knowledge/experience with a case where I am Hep B positive along with HIV. I guess I'm most nervous about the side-effects and how it will effect my day-to-day activities (especially my work/job). I have a job where I interact with customers/patients all day long and with management. Thanks in Advance!

Tony

-------------------------
Tony in Virginia


 



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Date Posted: Tuesday May 30, 2006 8:25 AM
Posted By: newt
Hey hello YNVA, welcome

Several things:

First Hep B testing is a four-part art and it is worth genning up on what the docs look at to decide if your Heb B is recent, long-term or gone away. The lessons section of this website has a handy table. Many people clear Heb B, even though it can take a while & the chance is less for HIV+ people. Heb B infection not cleared after 6 months is considered chronic. The treatment options for chronic HBV infection are limited, but improving. Whether to treat will depend on how much harm, if any, the Heb B is causing to your liver. Treatment options for Hep B/HIV are listed here. Your Hep B may turn out to be critical and complicted, it may be completely unimportant, it's hard to say, depends what your body does with the infection.

Second, when you come to start HIV combo, if you still have Hep B, your combination should include tenofovir (Viread) + 3TC (Epivir) or FTC(Emtriva), since these drugs are active against Hep B also. Truvada = tenofovir+ FTC.

Third, whether Sustiva is a good idea for Hep B co-infected individuals: a good question, since it can be hardish on the liver. For people with liver damage (eg high liver enzymes) an alternative may be worth considering. Also, from the customer service/work point of view, Sustiva can affect mood and cognitive function, especially at the beginning. Many people get used to this effect, but if a clear head is important, then do ask your doc about a protease inhibitor (PI) based combo.

The gold-standard PI for first-line therapy is Kaeltra, but many others are good. 96 week results for Reyataz (atazanavir) boosted with a small dose of ritonavir show it to be as effective, and this PI is gaining popularity as a first-line combo. It is a popular choice in London clinics for Hep B/C co-infected people because of the low amount of ritonavir needed as a booster (therefore less stress on the liver).

Fourth, by the book & yr numbers, treatment is not necessary at present. You have time to wait and see how the trend develops. A declining CD4 and rising viral load is an indication to consider starting, but me, personally, I would want 2 more rounds of test to establish a trend. Esp. to look at the Hep B info - Is it still present? If so, is it active or under control? If the Hep B appears to be resolving itself I would definitely try and wait til this clears before starting HIV treatment.

Bear in mind that CD4 counts vary by +/- 50, and viral load test by a factor of 3 (eg a viral load of 90,000 could really be 270,000 = 3 times higher or 30,000 = 3 times lower).

Fifth, if you do have chronic Hep B, this can flare up on starting combo containing tenofovir, 3TC or FTC.

Sixth, personally, I can testify to the effects of Hep B co-infection,which left me wiped for 12 months before it cleared.

Seventh, guidelines recommend you get vaccinated against Hep A, if you have not already done so.

Good luck.

- matt

-------------------------
Fate / Up against your will / Through the thick and thin
- Echo and the Bunnymen

 05/30/2006 00:25:57|U


 

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Date Posted: Wednesday May 31, 2006 2:36 AM
Posted By: YnotinVA
First! Thanks Matt for all of your info. I never knew I had Hep B until I was in the hospital last Nov. (2005) for the Acute Retina Necrosis. They said I had tested positive for it but it was resolved. I also had Hep A about 10 years ago which resolved itself (long before I knew I was HIV+). I tested negative for Hep C. My liver numbers are not elevated and I've been told by the docs they are ok (whatever that means). Though I seem to have had Syphllis for a very long time (I"m guessing more than 7 years), and it was discovered to be in my spinal fluid (via a lumbar puncture test). They first tried treating it with the 3 shots of penecillin but it still showed up after 3 months. So then they put me on the penecillin IV for 10 days/24hrs (I just completed the IV treatment on May 9th). I haven't had my new labs yet after finishing the IV treatment...but the doc is sure that it's now gone. My doc said that the HIV and Syphillis can work together and cause my numbers to be misleading. So I'm kind of anxious to see what my CD4/VL is once this syphllis has cleared up. With this is in mind, I'm wondering why my doc is wanting to start me on meds, when he even admitted that my numbers could be askew due to the syphllis. But he said I'm no longer asymptematic since I have had an "event" (the acute retina necrosis) and I should seriously consider starting treatment witht he Truvada and Sustiva. I told him I'd rather wait until we get a good read on my numbers after the syphllis has been cleared up. So am I holding out for the inevitable or should I just give in and do what he recommends? I guess it depends on if you believe in the hit early and hit hard approach.

Again...thank you so much for your valuable information!!
Tony

-------------------------
Tony in Virginia


 

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Date Posted: Wednesday May 31, 2006 2:48 AM
Posted By: newt
Hh has a point on your nos, and on the, er, "event", but I would sort the syphilis first, or at least try and sort it. Plus give serious thought to whether you want to do Sustiva or another drug. There's no rush. Good that your Hep B is cleared up though. My clinic wouldn't count the herpes as an "event" interestingly (aparently shingles is out as an OI there these days). Starting combo now wouldn't really count as hit early, it would count as starting in very prudent time, and if the "event" is counted in as a defining moment, would is in line with US guidelines. matt.

-------------------------
Fate / Up against your will / Through the thick and thin
- Echo and the Bunnymen

 
Title: Re: what about old threads & recently asked questions
Post by: newt on May 31, 2006, 07:18:07 pm
Yep, that's the way to do it

I was more thinking for personal reference to save typing, but some of the threads deserve reposting, esp. on T-20 ans lipodystrophy

- matt

PS- can we have a fresh Time Out thread please
Title: Re: what about old threads & recently asked questions
Post by: Ann on May 31, 2006, 07:28:54 pm


- matt

PS- can we have a fresh Time Out thread please


We will Matt. Like you, my worst sin is laziness. I should have had it ready already, but I've been putting it off all week. It's going to be included in  a "Welcome" sticky thread, similar to the one in the "Am I" forum. Someone said a while back in the old forum that the Time Out sticky was a little unwelcoming and I took that comment on board. So, as a result, the Time Out info will now appear as part of the Welcome thread. Which reminds me, I need to mention Time Outs in the "Am I" Welcome thread as well.

I'll get on it first thing in the morning. Right now I'm off to beddy-byes.

~yawn~

Ann
Title: Re: what about old threads & recently asked questions
Post by: gerry on June 04, 2006, 08:02:51 pm
Hi Ann,

I tried reposting one of the Fuzeon threads.  One of the problems is if the thread is too long, there is a limit of 20000 characters to a post, so I had to cut them into several posts.  But I do agree with Matt that there are several threads that would be difficult to duplicate, so reposting them here would be a good idea before they are lost forever.

Gerry
Title: Re: what about old threads & recently asked questions
Post by: DingoBoi on June 29, 2006, 12:54:48 am
since i noticed someone reading this thread as a guest, I'll post the recent info here.   

To access the old forums, please look to the CONTENT navigation box on the left and at the very bottom link is a link to ARCHIVED FORUMS which will bring you to view the old forums.
Title: Re: what about old threads & recently asked questions
Post by: J.R.E. on July 01, 2006, 09:04:08 am



Or, you can click here :


 http://www.aidsmeds.com/Fusetalk/index.cfm