Mixed News from Blood Work

[Lou-ah-vull]

I have my newest set of labs back this afternoon.  My CD4 is up to 499....my % is up to 38.4%....and my viral load is now <50 undetectable.  Fantastic news!

Unfortunately, I had another lipids panel.  Many of you will remember that within a few months of starting my combo   I had high lipids.  This happened the week before I left for AMG.  At that time, I did not want to consider changing meds because I was not yet undetectable.   My triglycerides were 480...now they are 860.  I am already taking TriCor to control triglycerides (I have been taking it for three years now.)  Also, my total cholesterol has increased from 224 to 286.  The lab report could not determine my HDL and LDL because of the high trigylceride numbers.  The doctor wants me to come in for an appointment to figure out the best way to control my HIV without affecting my lipids adversely.

These numbers tell me that I cannot remain on my Kaletra and Combivir indefinitely.  I have tolerated both extremely well with minimal side effects (not including the bad lipids.)  It will help me to get some idea about good options as I explore making a change in my therapy.

Gary 

[Longislander]

Hey Gary,
Well congrats on those HIV #'s and I hope you find the right combo for you~

[bear60]

Impressive!!

[Queen Tokelove]

Great numbers. Has the Tricor helped you at all? I am wondering because my doc has me on that hoping it will boost my hdls. Keep us posed...

[Lou-ah-vull]

Tricor was working for me well until I started my Kaletra/Combivir last May.  Now my triglycerides are sky high, even though I am taking Tricor everyday.  I am pretty sure I am going to have to switch HAART meds very soon.

Gary

[aztecan]

Gary,

The viral load and CD4 numbers are great.

Now, about those lipids. I think the Kaletra is doing a number on them. Combivir can affect them, but not to the degree the Kaletra does.

Since you are doing so well HIV-wise, might it be possible to switch the Kaletra for another PI?

Another option might be to trade out the Kaletra for a non-nuke, such as Sustiva, which doesn't affect the lipids.

I think you and your doc should have a heart-to-heart.

In the mean time, have you changed your diet? Maybe that will help some. Also, adding fish oil capsules couldn't hurt.

I take 4,000 mgs a day and it has helped keep my triglycerides in check. Maybe they will help lower yours as well?

Also, there have been very good results using Pravachol and Zetia together as a combo. There was a Spanish study that showed very good results when they were taken by possies having lipid issues as a result of the meds.

I have been taking it for about a month and will get my lipids checked in a few weeks to see if they are doing anything for me.

Wish I could be more help. Let me know what your doc says.

HUGS,

Mark

[AlanBama]

Hey Gary,

Great numbers!   Those triglycerides are pesky aren't they?   Mine used to stay sky high all the time......then, the "HIV Gods" smiled on me and mine leveled out and have been in "normal" range for several years now.   Don't ask me why, I certainly didn't do anything differently.    You most likely will have to switch your combo, at some point....it's just another bridge to cross in the journey.

hugs,

Alan

[Lou-ah-vull]

Dr. Gallant (Johns Hopkins website) says it is time for me to switch.  He says triglycerides over 800 necessitate an immediate switch...especially because I am already on trigylceride lowering medicine (Tricor.)  I see my doctor on Tuesday.  We are going to discuss alternatives. 

Any ideas or suggestions?

Gary

[gerry]

If you want to stay on a PI, Reyataz/Norvir + Truvada or Epzicom would be a couple of good choices.  If you are considering dropping the PI and using an NNRTI instead, Atripla (or Sustiva/Truvada) or Sustiva/Epzicom would be good options.  Either options would also drop the AZT, but if you want to stick to the Combivir and add it to Reyataz/Norvir or Sustiva, those are fine as well.  These assume your baseline genotype test do not show resistance to any of the meds.

[Lou-ah-vull]

My baseline shows no resistance to any meds.  As best as I can tell, I have had no problems with the Combivir.  There has been some tiredness and more frequent headaches, but as I hear others tell of their "side effects" I would have to say mine are tolerable and fairly normal.  Clearly though, the Kaletra is causing dangerous lipid problems, so I know that it has to go.  I have had excellent (really superior) virological control with this regimen, so the temptation is to try the more lipid friendly PI (reyataz and norvir) and keep the Combivir.  At the same time, I don't want to keep changing things, so moving to Atripla might be good.  I don't have a good feel for it yet...any advice or thoughts to consider will be appreciated! 

Thanks Gerry...it always reassures me when you weigh in on my posts!

Gary

[FiercenBed]

iv asked this question 2 or 3 times w/ no reply.....what is amg?

[poet]

Fierce, most likely Aids Meds Gathering, about which there is a forum here.  Sometimes an official one and sometimes, as with the NYC venture, an informal one of people who happen to be somewhere at the same time.  I may, however, stand corrected on this.

Back to Gary, congratulations on getting to this point.  Thankfully we have Mark and Gerry and others who can fill pages with options.  Best, Win