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Main Forums => Living With HIV => Topic started by: pozguy75 on January 07, 2007, 11:30:59 pm

Title: New Mutation!!
Post by: pozguy75 on January 07, 2007, 11:30:59 pm: Well, I just got my latest genotype back...and come to find out my little HIV darlings have mutated and I am now resistant to Combivir! I have to make yet another med switch, this makes two in one month! Yuck! Oh well...we will see...
Title: Re: New Mutation!!
Post by: thunter34 on January 07, 2007, 11:32:48 pm: I'm sorry tp hear that, doll. That sucks.
Title: Re: New Mutation!!
Post by: koi1 on January 08, 2007, 12:10:40 am: Hey,

Sorry to hear about that. Did the doc have any idea why this happened? I hope they will find a kickass combo for you soon.

rob
Title: Re: New Mutation!!
Post by: Blixer on January 08, 2007, 12:13:09 am: Sorry to hear about the resistance. Hope your doc comes up with a combo that is easy on you but gives heck to the virus.
Title: Re: New Mutation!!
Post by: lydgate on January 08, 2007, 12:20:17 am: Sorry to hear about this bud. Two med switches in a month, that's rough. Are you resistant to both AZT as well as 3TC? I'm pretty sure you'll get expert suggestions from people here. And you seem to have an amazing pragmatic attitude, which rawks. (I learn new words from Ameds every day ;D )
Title: Re: New Mutation!!
Post by: skeebo1969 on January 08, 2007, 12:27:00 am: Damn Jer sorry to hear this..
Title: Re: New Mutation!!
Post by: cubbybear on January 08, 2007, 12:35:33 am: Hey Sexy,

Bugger about the resistance. Here's to the next combo kicking hiv butt. Keep us up to date, I'm sure you will.

Love ya guts.
Matt
Title: Re: New Mutation!!
Post by: Queen Tokelove on January 08, 2007, 01:54:54 am: Sorry to hear about the resistance, sweetie...I'm sure they will come up with something that will help you make a comeback. Stay strong!
Title: Re: New Mutation!!
Post by: Eldon on January 08, 2007, 01:58:24 am: (http://i119.photobucket.com/albums/o134/forfun_06/3338477911.jpg)

Hey Jeromy,

Sorry to hear the news about your mutation. I send you my best wishes for the best possible outcome.

"What can I notice right now that makes me smile?"
Title: Re: New Mutation!!
Post by: pozguy75 on January 08, 2007, 10:12:16 am: Yep, it appears that I have a resistence with both AZT and 3TC...SUCKS!! So, I am still good with Kaletra, so hopefully I won't have to switch up everything!

Calling the doc today...
Title: Re: New Mutation!!
Post by: Iggy on January 08, 2007, 10:20:26 am: .
Title: Re: New Mutation!!
Post by: aztecan on January 08, 2007, 10:22:43 am: Hey Jeromy,

Does your GART show whether you are resistant to all NRTI's? Just askin . . .

I hope whatever you switch to kicks butt.

BIG HUGS,

Mark
Title: Re: New Mutation!!
Post by: Catman on January 08, 2007, 10:37:50 am: Check with your doctor if it's time to begin with Fuzeon. It has been the only med to get me undetectable in 20 years and I am also resistant to everything else till last year. Let's see if 2007 brings the new meds people are talking about. I'm sending you a private email now so check it out later... :(
Title: Re: New Mutation!!
Post by: GSOgymrat on January 08, 2007, 10:39:32 am: How reliable are those genotype tests? I'm skeptical, not about your case but the test in general.
Title: Re: New Mutation!!
Post by: pozguy75 on January 08, 2007, 10:42:37 am: Quote from: aztecan on January 08, 2007, 10:22:43 am
Hey Jeromy,

Does your GART show whether you are resistant to all NRTI's? Just askin . . .

I hope whatever you switch to kicks butt.

BIG HUGS,

Mark

Nope just the Combivir at this point...
Title: Re: New Mutation!!
Post by: allopathicholistic on January 08, 2007, 10:50:42 am: Quote from: GSOgymrat on January 08, 2007, 10:39:32 am
How reliable are those genotype tests? I'm skeptical, not about your case but the test in general.

Hear hear. Good reminder that we pozzies have the right to question everything
Title: Re: New Mutation!!
Post by: J220 on January 08, 2007, 11:10:30 am: Regarding the genotype tests, coincidentally I just read over at the research forum that there is a report of a new hiv test with " a level of sensitivity that makes the assay about 1,000 times more sensitive than the most widely used assays on the market for detecting drug-resistant HIV viruses".

http://forums.poz.com/index.php?topic=7587.0

Seems they are ready to patent the test, so once that is done, it could be before the end of the year, maybe even mid-year that this test could be available. Sound like a great tool.

Not sure if this is something that helps you now, but maybe you can contact Duk Universtiy and see if you can "volunteer" for the test. You never know!
Title: Re: New Mutation!!
Post by: Christine on January 08, 2007, 11:12:31 am: Damn mutations...And another med switch...

Sending good thoughts and hugs your way that things improve!
Christine
Title: Re: New Mutation!!
Post by: LatinAlexander on January 08, 2007, 11:55:41 am: With you in my thoughts boy!

Alex
Title: Re: New Mutation!!
Post by: Longislander on January 08, 2007, 01:05:02 pm: Sorry to hear this buddy, keep up the good attitude. Hope the next is a winner!
Title: Re: New Mutation!!
Post by: Life on January 08, 2007, 01:17:03 pm: Jeromy, I am sorry to here this but hopeful your doctor finds the puzzle fix... Jeromy did you have a resistant virus to begin with? I was under the impression you have been on meds for not a very long time..

We are thinking about you...
Title: Re: New Mutation!!
Post by: budndallastx on January 08, 2007, 01:49:10 pm: Wishing you the best and hope the next combo is the one !

Tom
Title: Re: New Mutation!!
Post by: Boo Radley on January 08, 2007, 03:41:23 pm: That is a drag about the resistance but your numbers look pretty good so surely you'll find the next combo works like a charm and has NO side effects!! I can hope, can't I?

Good luck Jeromy!

Boo
Title: Re: New Mutation!!
Post by: poet on January 08, 2007, 03:58:19 pm: Hey Jeromy, sorry like everyone else to hear about your resistance problem. One good thought which came to me is that given the two drugs involved, it may be how old and so passed around they are, rather than your virus somehow cleverly working around a brand new one/type. With fingers crossed for a quick resolution, Win
Title: Re: New Mutation!!
Post by: woodshere on January 08, 2007, 04:06:48 pm: Jeromy, Sorry to hear the news, hopefully your next combo will have as positive an affect for you as your great attitude, wit and devilish demeanor has for all of us on these forums!

Cheers,
Woods
Title: Re: New Mutation!!
Post by: newt on January 08, 2007, 07:34:05 pm: Bad luck

(and, erm, which mutations exactly?)

- matt
Title: Re: New Mutation!!
Post by: aupointillimite on January 08, 2007, 08:12:10 pm: Quote from: pozguy75 on January 08, 2007, 10:42:37 am

Nope just the Combivir at this point...

Thank bloody God!

I was worried you ran out of all your nukes...

I'm glad that you haven't, dude... I hope it turns out OK.
Title: Re: New Mutation!!
Post by: SoSadTooBad on January 08, 2007, 09:05:48 pm: Sending good thoughts your way...

sstb
Title: Re: New Mutation!!
Post by: Jody on January 08, 2007, 09:34:53 pm: Jeromy...Sorry to hear the news about twice in one month getting these results...Hope you find a combo that suits you well. Keep us posted.

Jody
Title: Re: New Mutation!!
Post by: Nadine on January 08, 2007, 09:37:59 pm: Wishing you the best Jeromy!
Title: Re: New Mutation!!
Post by: mrtallguy on January 08, 2007, 10:08:19 pm: Jeromy....There is a great light that shines from you....your smile is more infectious than any disease known to man! So with these powers of light this moment of darkness will not last! Remember that the sun shines every day....although the clouds would have us believe otherwise! Do not put power in the clouds my friend for your LIGHT will prevail!!

Be Well, Good Luck, Hugs, and.... :-*...okay I'll stop there.....for now!

Craig
Title: Re: New Mutation!!
Post by: ndrew on January 08, 2007, 10:53:30 pm: Sorry to hear this Jeremy... wishin' u the best...

Drew
Title: Re: New Mutation!!
Post by: RobT on January 08, 2007, 11:01:24 pm: Jeromy-
Like the posting prior to mine said that ur smile is infectious.

Sorry to hear about ur mutation. Unfortunately I am not sure how that is cuz I have been on the same combo for over a yr, but I think I understand how stressful it can b for changing meds that often. To my understanding, each med(s) have different side-effects. Changing between ediff meds in a given month must have given ur share of side effects. I again have never been on either, so forgive me for my lack of knowledge on either of the meds.

I just hope that ur doc has some suggestions of which med to take. Best of luck!

RobT
Title: Re: New Mutation!!
Post by: thirtysomething on January 09, 2007, 12:24:21 am: sorry to hear that Jeromy. Be strong! :)
Title: Re: New Mutation!!
Post by: J.R.E. on January 09, 2007, 07:50:58 am: Quote from: newt on January 08, 2007, 07:34:05 pm
Bad luck

(and, erm, which mutations exactly?)

- matt

Jeromy,

Sorry to hear whats happenning. But see if you can get a copy of that report, and perhaps post some of the information. You may get some ideas or suggestions.

Ray
Title: Re: New Mutation!!
Post by: pozguy75 on January 09, 2007, 01:12:16 pm: Quote from: J.R.E. on January 09, 2007, 07:50:58 am

Jeromy,

Sorry to hear whats happenning. But see if you can get a copy of that report, and perhaps post some of the information. You may get some ideas or suggestions.

Ray

I have attached a copy of the report here...I am resistent to the following:

Emtriva
Epivir

With a reduced susceptibility to Zerit, Retrovir, and Viread.

I also now have Dual-Tropic HIV or Mixed Population...I have both CCR5 and CXCR5 tropisms. This is from being on the Marviroc study: the CCR5 entry inhibitor. What seems to have happened, at the beginning of the study I was only CCR5, and I have now changed tropisms...so, I am no longer able to take a CCR5 inbitor (fusion or entry). Meaning that Fuzeon is no longer an option for me.

So...I will chat with the doctor this afternoon and see what the options are going to be...

[attachment deleted by admin]
Title: Re: New Mutation!!
Post by: Strayboy74 on January 09, 2007, 03:09:20 pm: *hug*

-joseph
Title: Re: New Mutation!!
Post by: Javicho on January 09, 2007, 03:35:37 pm: Sorry to heard that Jeromy, I hope the next one it will work for you :-*

J.
Title: Re: New Mutation!!
Post by: pozguy75 on January 09, 2007, 03:47:10 pm: Well...doctor called and because of my latest results where my CD4 counts are good and my VL is undetectible, we have decided to keep my regimen for now. It seems to working...so we will keep an eye on things over the next couple of months and get a better guage in March.

So...wait and see as they say...
Title: Re: New Mutation!!
Post by: aupointillimite on January 09, 2007, 04:05:01 pm: I believe I read somewhere that resistance to Epivir made the virus less virulent somehow... and my doc said that even when she had patients who were resistant to it, she'd keep them on Epivir...
Title: Re: New Mutation!!
Post by: Tucsonwoody on January 09, 2007, 04:18:17 pm: Here is a little bit of the article on aidsmeds that might explain why stay with Epivir still helps:

However, Epivir resistance might make the virus even more sensitive to other NRTIs, most notably Retrovir (even if HIV has mutations in its structure that would normally cause it to be resistant to Retrovir) and Viread.

http://www.aidsmeds.com/drugs/Epivir.htm

Whatever happens hope ya stay healthy and find a good combo to kick HIV's ass!

(Oh and keep making porn of course)
Title: Re: New Mutation!!
Post by: fearless on January 09, 2007, 07:01:43 pm: Bit of a bummer, Jeromy.

All the best.
Title: Re: New Mutation!!
Post by: newt on January 09, 2007, 07:24:28 pm: Mutation-wise - theroetically interesting but practically boring. We share 6 mutations, but, strangely, have never met :D - matt
Title: Re: New Mutation!!
Post by: whizzer on January 09, 2007, 07:36:53 pm: Jeromy,

Fuzeon is neither CCR5 nor CXCR4 tropism dependant. It binds to neither receptor. Fuzeon (ENF) binds to the first heptad-repeat (HR1) in the GP41 subunit of the viral envelope glycoprotein, thus preventing conformational changes required for fusion of the viral envelope and CD4 cell membrane. It's mechanism of action is independent of the tropism . The prescribing information indicates ENF is equally active in vitro against clades A, AE, C, D, E, F, and G as well as R5, X4, and dual-tropic viruses.

I don't see ENF on either of the genotype reports you listed, and I'm far too lazy to look up what mutations are resistant to ENF. Anyways, it may still be an option for you in the future..

It is a moot point since you are currently going to stay the course with your current regimen (which to me seems like a good call, if it ain't broke, don't fix it).

As a matter of curiosity, how can they get an accurate genotype if your VL is undetectable (I'm assuming you mean less than 50)? I wasn't aware it could be done.

-Whizzer
Title: Re: New Mutation!!
Post by: allopathicholistic on January 10, 2007, 12:05:58 pm: yup, wait and see as they say jeromy. we'll be thinking of you

Quote from: whizzer on January 09, 2007, 07:36:53 pm
As a matter of curiosity, how can they get an accurate genotype if your VL is undetectable (I'm assuming you mean less than 50)? I wasn't aware it could be done.

i'm curious too ....inquiring minds want to know
Title: Re: New Mutation!!
Post by: Tucsonwoody on January 10, 2007, 12:17:33 pm: This may explain about low VL and test:

Resistance testing may be useful for some with 'undetectable' viral loads

Genotypic resistance testing in individuals with an 'undetectable' viral load may be more reliable than currently thought, according to a report published in the September issue of the Journal of Acquired Immune Deficiency Syndromes. They argue that resistance testing in those with very low detectable HIV RNA levels (e.g. between four and 75 copies/ml) may be useful to inform treatment decisions in individuals who are experiencing viral load 'blips' or an unexpectedly slow response to a change in their antiretroviral regimen.

Full article at: http://www.aidsmap.com/en/news/632C4768-4E19-4D45-8AA0-0A6EF4075613.asp
Title: Re: New Mutation!!
Post by: pozguy75 on January 10, 2007, 12:53:29 pm: Quote from: whizzer on January 09, 2007, 07:36:53 pm
Jeromy,

Fuzeon is neither CCR5 nor CXCR4 tropism dependant. It binds to neither receptor. Fuzeon (ENF) binds to the first heptad-repeat (HR1) in the GP41 subunit of the viral envelope glycoprotein, thus preventing conformational changes required for fusion of the viral envelope and CD4 cell membrane. It's mechanism of action is independent of the tropism . The prescribing information indicates ENF is equally active in vitro against clades A, AE, C, D, E, F, and G as well as R5, X4, and dual-tropic viruses.

I don't see ENF on either of the genotype reports you listed, and I'm far too lazy to look up what mutations are resistant to ENF. Anyways, it may still be an option for you in the future..

It is a moot point since you are currently going to stay the course with your current regimen (which to me seems like a good call, if it ain't broke, don't fix it).

As a matter of curiosity, how can they get an accurate genotype if your VL is undetectable (I'm assuming you mean less than 50)? I wasn't aware it could be done.

-Whizzer

Well, the genotype was collected on Nove 16, and it took 6 weeks to get the results back. It was during that time that we switched from the Maraviroc to the Kaletra and remained on the Combivir. I wasn't undetectable then...My VL was aprroaching a little over 1000, so there was enough there to collect the data.

Now, my VL is <75 which was they are considering to be undectible...so, with the way my numbers are now, we aren't going to worry too much about the mutations until we see numbers slipping...

And thank you SO much for the info on Fuzeon, apparently I was misinformed...phew! But I can tell you I am no longer able to take the CCR5 entry inhibitors now...
Title: Re: New Mutation!!
Post by: cmhjeff on January 10, 2007, 02:20:28 pm: Quote from: pozguy75 on January 09, 2007, 03:47:10 pm
Well...doctor called and because of my latest results where my CD4 counts are good and my VL is undetectable, we have decided to keep my regimen for now. It seems to working...so we will keep an eye on things over the next couple of months and get a better gauge in March.

So...wait and see as they say...
I was thinking the same way since your current cocktail is controlling your virus I wouldn't be so quick to change. My original doctor changed my meds so often trying to get me undetectable that my genotype had me resident to most of the meds a year ago when I got the PML so my doctor put me on Trizivir which the report showed some Resistance but here I am undetectable. We'll all be here with you waiting until March.
Hugs
Title: Re: New Mutation!!
Post by: thunter34 on January 10, 2007, 02:36:33 pm: Jeromy,

I wanted to pose what might be viewed as a bit of a sensitive question here, but I hope you'll appreciate me raising it both out of concern for you personally and to discuss the question in the broader sense once again:

Is your doctor aware at all of your current porn work?

Do you think that there might be a potential for setting yourself up for mutation problems through the type of sex activity involved with that particular style of porn work? I know the data behind the concepts of ''reinfection'' and/or ''superinfection'' are up for debate, but I was wanting get some current word from anyone more in the know than myself about what the latest word on this topic was. It just crossed my mind that if there was a lot of fluid exchange between yourself and someone else who was already Combivir resistant, wouldn't that expedite resistance in you? If so, might that problem potentially repeat itself?

Anyone with some info to offer on this?
Title: Re: New Mutation!!
Post by: newt on January 10, 2007, 02:48:31 pm: "It just crossed my mind that if there was a lot of fluid exchange between yourself and someone else who was already Combivir resistant, wouldn't that expedite resistance in you? "

Theoretically, yes. But (1) the source would have to have enough virus to transmit - if he was undetectable this would be unlikely ... (2) the host would have to be immunologically receptive - who knows?

The most likely explanation for J's mutations, which don't seem that important anyway, is that he was on a combo that didn't get his viral load undetectable.

- matt
Title: Re: New Mutation!!
Post by: thunter34 on January 10, 2007, 02:50:44 pm: Muchas gracias!
Title: Re: New Mutation!!
Post by: pozguy75 on January 10, 2007, 03:55:27 pm: Yes, I am totally upfront with my doctor...he knows all...which is good, so it's not like I am behind his back or anything...

And the doctor is also pretty convinced that the study drug Maraviroc wasn't able to keep me undetectable and allowed my virus to blip more that once...so, since being put on Kaletra along with the existing Combivir, my numbers have gone back to undetectable...

Thanks thunter!! Love you man...and no question is sensative question here...that's why I am here...

Thanks Matt for the info too!!

My God you both are going to be living in my dreams tonight! I may even have a day dream as well!! ;D
Title: Re: New Mutation!!
Post by: thunter34 on January 10, 2007, 05:12:03 pm: Wuv and hugs and fat, fat sloppy wet kisses, Jeromy! :-*

I guess the bottom line (and somehow we always end up discussing bottoms with Jeromy- LOL) is that this mutation / blip thing is not as rotten as it first seemed.

That is good to hear.
Title: Re: New Mutation!!
Post by: pozguy75 on January 10, 2007, 06:08:01 pm: I am always the bottom in these situations...
Title: Re: New Mutation!!
Post by: thunter34 on January 10, 2007, 06:12:32 pm: Quote from: pozguy75 on January 10, 2007, 06:08:01 pm
I am always the bottom in these situations...

Revised to read: MOST situations! ;D
Title: Re: New Mutation!!
Post by: Amosboy on January 10, 2007, 08:40:21 pm: Jeromy,

I have no doubt that you will end up on top of this "particular" situation. You have a lot of people sending you the best, myself including. A little more TLC may be in order. You'll be doing somersaults before it's all over and everyone will surely give you a STANDING ovation...keep that smile on your face.

Brooks
Title: Re: New Mutation!!
Post by: pozguy75 on January 10, 2007, 11:50:22 pm: Nothing but smiles here...and Brooks, yes, kissing is underrated!
Title: Re: New Mutation!!
Post by: GSOgymrat on January 11, 2007, 02:11:31 am: Quote from: pozguy75 on January 10, 2007, 11:50:22 pm
and Brooks, yes, kissing is overrated!

BLASPHEMY!
Title: Re: New Mutation!!
Post by: lydgate on January 11, 2007, 02:23:17 am: Just a typo thing on Jeromy's part, keep the large fonts in check now. Or is it a Freudian (or, horror of horrors, deliberate) slip?!

Kissing rawks.
Title: Re: New Mutation!!
Post by: pozguy75 on January 11, 2007, 09:19:23 am: Quote from: GSOgymrat on January 11, 2007, 02:11:31 am
BLASPHEMY!

OOPS I meant to say Underrated!!

I am revising my reply!
Title: Re: New Mutation!!
Post by: Amosboy on January 11, 2007, 08:20:13 pm: Jeromy,

I didn't even give the first response a second glance. Something told me that couldn't be true ;) And I was fully prepared to use my magic lasso on you to get to the truth of the matter. Oh well...you had to go and edit your response. How do you like the T-shirt design? "Sluts Unite" actually reads across the back of the shirt...pretty hot, huh? I hope you are having a blast in DC.

(http://home.carolina.rr.com/music4mania/man sex...it does a body good - small.jpg)

Brooks
Title: Re: New Mutation!!
Post by: thunter34 on January 11, 2007, 08:24:06 pm: Lordy! Is it DC time for them all already? If so, that means Catman is also off the boards here. And who else? Someone else said they were going to that thing.

(I'm getting sweaty just thinking about the tales we will hear on their return!)
Title: Re: New Mutation!!
Post by: aupointillimite on January 11, 2007, 08:25:31 pm: Wait... Jeromy's in DC?

No fair! I would've taken some time (and my Suicide Girl friend who does modeling for Club Bound in DC) to go to whatever he's at.

Stupid vacation. ;)

Have fun in the city of my birth, Jeromy!
Title: Re: New Mutation!!
Post by: Amosboy on January 11, 2007, 08:29:44 pm: Now, now boys...I'm sure we'll eventually get to see all of the sordid details on DVD...maybe even a gangbang scene in a hotel room.

Motel 69..."We'll leave the light on...and the lube on the table for you"

In any event, I glad that Jeromy is moving forward and keeping his good spirits about him. And I'm sure he's making someone very happy right about now.

Brooks
Title: Re: New Mutation!!
Post by: RapidRod on January 11, 2007, 08:33:07 pm: Jeromy, don't sweat it. You will die by screwing yourself to death or by a light rig falling in the tub during a hot erotic filming scene in the bath. ;)
Title: Re: New Mutation!!
Post by: thunter34 on January 11, 2007, 08:39:55 pm: I have spied this Suicide Girl of whom Benj speaks.

And she is hot

Like lava hot

(Again, gay...not blind)
Title: Re: New Mutation!!
Post by: aupointillimite on January 11, 2007, 08:49:34 pm: Quote from: thunter34 on January 11, 2007, 08:39:55 pm
I have spied this Suicide Girl of whom Benj speaks.

And she is hot

Like lava hot

(Again, gay...not blind)

I know. I had her dancing on my coffee table for my Seven Years Still Queer Party last year.

It was an ironic treat for all who attended.
Title: Re: New Mutation!!
Post by: gerry on January 11, 2007, 11:43:35 pm: Hi Jeromy,

The only relevant mutation you have that is known to affect drug susceptibility is the M184V and it does show in the test that the virus is completely resistant to Epivir and Emtriva. However, I do not see anything in the test that indicates that the virus has reduced susceptibility to AZT, d4T and Viread.

Your dual-tropism may have caused the Maraviroc to fail, which allowed the virus to break through and most likely allowed the development of the M184V mutation (which is the first mutation expected in this situation). But since it was caught early, it averted development of resistance to AZT (so the AZT in the Combivir is actually still working).

Using Kaletra makes very good sense in this situation; it is potent and has a high genetic barrier against resistance. That, plus AZT (which tends to work better in the presence of M184V) is likely enough to cause maximal viral suppression. You are still essentially on dual therapy, even though it may be enough to suppress the virus. If you wish to add another drug to make sure you have 3 active drugs in the combo, Viread would be the logical one to add. The M184V also tends to make it work better, so you still want to keep the 3TC.

Cheers,
Gerry