Update on switch to Dovato from Biktarvy

[Dogman]

Good morning, I would like to give an update on my recent switch from Biktarvy to Dovato.

I have been on Dovato now for a month, after being on Biktarvy for 9 months (initial treatment).

my VL stayed UD, my CD4's however dropped from 470 down to 400, and my CD4/CD8 % dropped from 17% to 14%. I have had a cold for about 1.5 weeks, which I'm hoping is the reason for the downtown in CD4's

Otherwise, the switch was without side-effects. I was hoping to have a CD4 of > 500 after nearly 12 months of treatment (initial CD4 was around 175).

I hope everyone is doing well

[Jim Allen]

I'm glad to hear you are doing well with the new treatment. How are you feeling/doing otherwise?


Not sure, are you expecting a change in HIV meds would somehow change your CD4 count? CD4 count will vary by even 100 points within a day, I could sneeze between tests, and the two tests would have a different count, All HIV meds do is suppress the virus; they don't change your CD4 counts, and to be honest, you should not even be looking at CD4 counts anymore.

Are worried about CD4 counts and if so why?

[Dogman]

I'm glad to hear you are doing well with the new treatment. How are you feeling/doing otherwise?

Apart from a cold, I feel just fine physically, I struggle big time mentally, which is slowly going away.

Not sure, are you expecting a change in HIV meds would somehow change your CD4 count? CD4 count will vary by even 100 points within a day, I could sneeze between tests, and the two tests would have a different count, All HIV meds do is suppress the virus; they don't change your CD4 counts, and to be honest, you should not even be looking at CD4 counts anymore.

No, I didn't expect anything CD4 wise from the new med, I'm happy i'm still UD. I have read many posts on CD4 count and while I was hoping for an increase, simply because they haven't gone up in 6 months, I'm not panicking about it.

Are worried about CD4 counts and if so why?

I am not particularly, I would like them to be in the "normal" range, but I guess that will come with time and patience.

Thanks for replying, hope you're doing good too!

[leatherman]

I was hoping to have a CD4 of > 500 after nearly 12 months of treatment (initial CD4 was around 175).

ugh. this is one of those wrong "hopes" I wish doctors would explain better.

ARVs sole purpose is to interrupt, at several different points, the life cycle of the HIV virus. The effect is that HIV is reduced, although sometimes it takes times, to undetectable. Once that happens, and as long as you remain undetectable, your body has the chance to replenish cd4s. Now how fast that happens is all up to the genetics that created your immune system. Some people rebound fast. Some don't. Some people have a "low" rebound. Some jump above 1000. So really the most important number to look at is the VL. As long as that remains low, HIV is unable to do much, if any, further damage to your body.

Of course, a lot of people end up caring about the cd4 number; but why? First, there's a huge number range of what is defined as "normal". The limits tend to be a little hazy too. is 400 or 500 the lower parameter? Is 1200 or 1600 a normal upper parameter? Then there's the pesky problem that the cd4 count is only a quantitative amount. The test can't determine the strength of those cd4s (a qualitative description). While most people need that average range of cd4s (400-1600), there are plenty of people who live healthy lives with cd4s in the 250-400 ranges.

Last, but not least, since cd4s can change by up to 100 points in one day, it's kind of hard to get anything other than a snapshot of the cd4 count at blood draw. That 400 result that you received could have easily been 300 or 500 on that same day. Sounds extreme, right? But if you did 4 cd4 tests in one day, you could quit easily see results all over that range.

Not to bore you with my 40yrs of living with HIV, let me tell you the short story of why worrying about cd4s is useless. My first test was a miniscule 5 cd4s. Ten years and a dozen regimens later, I was lucky to have a whopping 225. Another 15 yrs after that I was up to 350. In that 25 yrs I hadn't returned to the hospital, had two bouts of flu and about 4 colds. Quite frankly, since the last time I was hospitalized with AIDS (30ish yrs ago) and got onto newer meds, I've been getting healthier and healthier. Oddly enough, in the last 3 yrs, my cd4s have jumped to 650, and the only sickness I've had in yrs was covid 2 yrs ago. For a long time, I was like you hoping to reach the "normal" range, until I realized that it didn't matter. Keeping medicated to stay UD was all it took. It may have taken nearly 30 yrs to get into the normal range; but when I did, nothing changed. I was just as healthy and happy as I had always been.

cd4 results are just a number, like blood pressure, that's too in flux to mean much - well, as long as they are above 200. Worry about keeping your viral load undetectable, and your cd4s will take care of themselves.

[Dogman]

ugh. this is one of those wrong "hopes" I wish doctors would explain better.

ARVs sole purpose is to interrupt, at several different points, the life cycle of the HIV virus. The effect is that HIV is reduced, although sometimes it takes times, to undetectable. Once that happens, and as long as you remain undetectable, your body has the chance to replenish cd4s. Now how fast that happens is all up to the genetics that created your immune system. Some people rebound fast. Some don't. Some people have a "low" rebound. Some jump above 1000. So really the most important number to look at is the VL. As long as that remains low, HIV is unable to do much, if any, further damage to your body.

I do understand this, I was just being hopeful that my CD4 rebounded rather than went backwards. But yes, apart from a pesky cold in the past week, I have felt perfectly normally physically.

Of course, a lot of people end up caring about the cd4 number; but why? First, there's a huge number range of what is defined as "normal". The limits tend to be a little hazy too. is 400 or 500 the lower parameter? Is 1200 or 1600 a normal upper parameter? Then there's the pesky problem that the cd4 count is only a quantitative amount. The test can't determine the strength of those cd4s (a qualitative description). While most people need that average range of cd4s (400-1600), there are plenty of people who live healthy lives with cd4s in the 250-400 ranges.

Last, but not least, since cd4s can change by up to 100 points in one day, it's kind of hard to get anything other than a snapshot of the cd4 count at blood draw. That 400 result that you received could have easily been 300 or 500 on that same day. Sounds extreme, right? But if you did 4 cd4 tests in one day, you could quit easily see results all over that range.

Not to bore you with my 40yrs of living with HIV, let me tell you the short story of why worrying about cd4s is useless. My first test was a miniscule 5 cd4s. Ten years and a dozen regimens later, I was lucky to have a whopping 225. Another 15 yrs after that I was up to 350. In that 25 yrs I hadn't returned to the hospital, had two bouts of flu and about 4 colds. Quite frankly, since the last time I was hospitalized with AIDS (30ish yrs ago) and got onto newer meds, I've been getting healthier and healthier. Oddly enough, in the last 3 yrs, my cd4s have jumped to 650, and the only sickness I've had in yrs was covid 2 yrs ago. For a long time, I was like you hoping to reach the "normal" range, until I realized that it didn't matter. Keeping medicated to stay UD was all it took. It may have taken nearly 30 yrs to get into the normal range; but when I did, nothing changed. I was just as healthy and happy as I had always been.

Please, never apologize, you do not bore me. I have read your posts over and over. I regard guys like you very highly, I have a couple of friends, who like you, went through the wars and are like you, still here, healthy and happy. I know we have it "easy", with the modern medicines etc.

cd4 results are just a number, like blood pressure, that's too in flux to mean much - well, as long as they are above 200. Worry about keeping your viral load undetectable, and your cd4s will take care of themselves.

Thank you, my doctor doesn't want to see me for 3 months, and yes, he also stated being UD is what to focus on. So thank you again, for your insight and reality check, I don't mean to sound like a whiney baby - it's just a struggle at times, I appreciate you and your valuable wisdom and experience.

[leatherman]

it's just a struggle at times

ain't that the truth? A big ol' truth about living with HIV. You're not whiney. You're just rightly concerned about your health - and it's just a struggle at times.

Hell. As much as HIV doesn't impact my life these days (a couple pills in the morning, a couple with dinner), this weekend while talking with my husband, our conversation slipped to the past. Right in the middle of a story about my bad times with HIV that I've told a million times (I've done a lot of speaking and advocacy work, so I've told my story a bunch), suddenly tears. Twenty-five years removed from being in the hospital struggling with HIV and there I was still struggling. 

I'm not saying most of my days aren't great, because they certainly are ; but no matter the happy talk, we (all of us living with HIV) get you and know even in the best of times, sometimes living with HIV is just a struggle.

your valuable wisdom and experience.

wisdom? I don't know about that. LOL I know a lot about some stuff that's all.

experience? ugh! too damn much. LOL All that "experience" just means I'm old now. ROFLMAO Even though I try not to ever act my age, having been in a hospital really close to dying on two different birthdays, I'm always been darn happy about getting older. It sure beats the alternative, even if it means I'm stuck with "wisdom" and "experience".

[Dogman]

ain't that the truth? A big ol' truth about living with HIV. You're not whiney. You're just rightly concerned about your health - and it's just a struggle at times.

To be honest, my health is pretty good, I have high BP which is managed, but hell I'm 60's. My struggle is the constant referenced to "diseased" in my doctor's reports. He often refers to AIDS - technically I don't have AIDS, I have the virus that causes it - and I'm being pedantic and in a form of denial, but being labelled as diseased, when I feel perfectly fine, good appetite, normal energy - really does my head in after every visit.

Hell. As much as HIV doesn't impact my life these days (a couple pills in the morning, a couple with dinner), this weekend while talking with my husband, our conversation slipped to the past. Right in the middle of a story about my bad times with HIV that I've told a million times (I've done a lot of speaking and advocacy work, so I've told my story a bunch), suddenly tears. Twenty-five years removed from being in the hospital struggling with HIV and there I was still struggling. 

Given what you ( and some people I know ), have been through moves me to tears, because I have not had to (and hope I don't) - I don't have anything to complain about, but it comes down to relevancy, and this is my reality, but I take your words on board. Hell a friend of mine, her  son just had his leg amputated because of diabetes, another friend is dying of bowel cancer. In perspective, so far, I'm doing ok. Can you see how I'm just verbally convincing myself here, but it is the truth.

I'm not saying most of my days aren't great, because they certainly are ; but no matter the happy talk, we (all of us living with HIV) get you and know even in the best of times, sometimes living with HIV is just a struggle.

Wisdom? I don't know about that. LOL I know a lot about some stuff that's all.

I think one of my things is, I'm not sure why it's a struggle. It's well managed, it's a virus. Everyone has virus' in them, yes it's a particularly nasty virus when not controlled, so I think a lot of my struggle comes back to the "diseased" label that I see on every correspondence from my doctor.

experience? ugh! too damn much. LOL All that "experience" just means I'm old now. ROFLMAO Even though I try not to ever act my age, having been in a hospital really close to dying on two different birthdays, I'm always been darn happy about getting older. It sure beats the alternative, even if it means I'm stuck with "wisdom" and "experience".

Getting old sucks, but the alternative sucks more. Again, thank you for putting things into perspective. I don't have a good support system (my own fault), and haven't discussed my situation with anyone but my doctor and one other member on here. I don't mean to rant, I'm just expressing to someone who's willing to listen and respond, for which I am honestly, extremely thankful for. :-)

[Tonny2]

               ojo.           Hello there!… i’m sorry that you are struggling with this term “disease “. To tell you the truth after 29 years I living with this condition, my doctor has never has mentioned the world disease, although, my card, theologist, he says that I have heart disease after putting a stem in one of my veins, which I don’t like it because I feel fine, but it is what it is… like you said, there are people who have it worse , like those friends you mentioned… about renting, we are here for you, don’t worry about it…hugs

[Tonny2]

         ojo.       * cardiologist… sorry for the typos…I’ve lived for almost 29 years with hiv and, I don’t recall ever shedding a tear for my condition not even when I started to lose my vision, maybe I need a good cry, it would help with my eye dry condition, but again, we all are different…wishing you the best dogman and don’t forget that we are here for you…hugs from Ohio, USA

[Dogman]

         ojo.       * cardiologist… sorry for the typos…I’ve lived for almost 29 years with hiv and, I don’t recall ever shedding a tear for my condition not even when I started to lose my vision, maybe I need a good cry, it would help with my eye dry condition, but again, we all are different…wishing you the best dogman and don’t forget that we are here for you…hugs from Ohio, USA

I'm sorry for your struggles, I've always thought I was strong minded - but this has done a number on me, but reading your story again, sheds a new light - and I never mean to dismiss anyone else's personal struggles - as you say we're all different. My struggles stem from anger, that despite having all the information and for as much as I can remember taking necessary precautions, I somehow still ended up in this boat - so my venting and frustration stems from me and my actions when I could have avoided it. I have read a lot of your posts, and again, it puts everything into perspective. I have friends who caught this years ago who've battled a battle I would have given up on, and they're still here, still smiling and living their lives. genuine hugs back to you sir. and thank you.

[Tonny2]

                 ojo.             Hi dogman!, i have two dogs…Don’t get me wrong, we are all here to vent and rant, as a matter of fact, I was typing a rant myself to post and when I was about to post my rant, I don’t know what i did, due to my blindness, that my rant West deleted, I felt so frustrated because it takes me a long time to type a post. But I said to myself, it is what it is…as I said, we are here to support each other, sharing our experiences and maybe help others by doing so…if you allow me to give you a suggestion, try to turn the page, right now what it matters is that you know you are pisitive, you treat it and try to be more pisitive about life so can can live a normal and happy life, if you still think that it’s something you can’t handle, seek professional help…reading your post, i thought that it would be a good idea to start a thread about the “horror” we’ve been through with this condition, if you knew what has happened to me, you would be surprised, anyway, I wish you the best and remember that you are not alone, we are here for you…more hugs


Ps. or keep my typos, I’m blind, well, legally blind.

[Dogman]

                 

ojo.             Hi dogman!, i have two dogs…Don’t get me wrong, we are all here to vent and rant, as a matter of fact, I was typing a rant myself to post and when I was about to post my rant, I don’t know what i did, due to my blindness, that my rant West deleted, I felt so frustrated because it takes me a long time to type a post. But I said to myself, it is what it is…as I said, we are here to support each other, sharing our experiences and maybe help others by doing so…if you allow me to give you a suggestion, try to turn the page, right now what it matters is that you know you are pisitive, you treat it and try to be more pisitive about life so can can live a normal and happy life, if you still think that it’s something you can’t handle, seek professional help…reading your post, i thought that it would be a good idea to start a thread about the “horror” we’ve been through with this condition, if you knew what has happened to me, you would be surprised, anyway, I wish you the best and remember that you are not alone, we are here for you…more hugs


Ps. or keep my typos, I’m blind, well, legally blind.

I apologize for not responding sooner, I tend to get here on bursts, and have been traveling a lot. You're a dog person with dogs, the most wonderful pets and friends we could hope for.  Thanks again for talking to me and give your dogs a big pat from me. hugs back.

[Dogman]

Just wanted to give an update on my own experience in switching from Biktarvy to Dovato 5 months ago.

I had been on Biktarvy for 7 months following my initial diagnosis, and it worked well and very fast, I was undetectable after 3 weeks (from VL of 100,000). I had some minor side-effects including facial wasting, not super bad, but enough that I am acutely aware of it. I switched to Dovato after discussion with my doctor in terms of one less drug. I posted an initial update after the switch, this is the 2nd update. My VL is still UD, my CD4's are up to 540 (from 370 3 months earlier, I know this number is unrelated to the drug) and I'm at 20% CD4/CD8 which is slowly getting towards "normal". I have experienced minor sleep pattern changes, but other than that no side-effects at all. I'm not sure if people are interested, but I like reading others experiences so figure someone may be interested in my experience. Wishing everyone a wonderful 2024.

[numbersguy82]

Just wanted to give an update on my own experience in switching from Biktarvy to Dovato 5 months ago.

I had been on Biktarvy for 7 months following my initial diagnosis, and it worked well and very fast, I was undetectable after 3 weeks (from VL of 100,000). I had some minor side-effects including facial wasting, not super bad, but enough that I am acutely aware of it. I switched to Dovato after discussion with my doctor in terms of one less drug. I posted an initial update after the switch, this is the 2nd update. My VL is still UD, my CD4's are up to 540 (from 370 3 months earlier, I know this number is unrelated to the drug) and I'm at 20% CD4/CD8 which is slowly getting towards "normal". I have experienced minor sleep pattern changes, but other than that no side-effects at all. I'm not sure if people are interested, but I like reading others experiences so figure someone may be interested in my experience. Wishing everyone a wonderful 2024.

Sounds like you are def on your way to a fantastic 2024 and beyond. I’m happy for you and please keep us posted!