Short-Cycle Therapy (5 days on/2 days off

[testii28]

Hello,

it has been a while that I didn't post anything.
I have been on therapy for about 3 months (Biktarvy).
VL: 57  CD4 approx. 500-600
My kidney values have dropped significantly.
GFR: 73 Creatinine :1,20
 
My doctor refused to change the therapy. There are not much alternatives (doctors) here where I am living. I think this TAF stuff inside Biktarvy cause the kidney issue.

Does anybody has experience with Short-Cycle Therapy (5 days on/2 days off).
Is it worth a try?
https://academic.oup.com/jac/article-abstract/77/3/747/6445130?redirectedFrom=fulltext

https://www.youtube.com/watch?v=0IrqHsak_7M

Thanks for your support.

[Jim Allen]

GFR: 73 Creatinine :1,20

It sounds okayish, at least if it were my results within 3 months I would not be too worried myself, I would drink more and monitor this but give it all some time to settle.

My doctor refused to change the therapy.

I am interested if you don't mind sharing; when you say the doctor refused, did they give a reason or context for it?

Does anybody has experience with Short-Cycle Therapy (5 days on/2 days off).
Is it worth a try?

Well, the link is for the rilpivirine combination four days on/three days off therapy. Are you considering this, and do you have access to these meds? I would urge caution given the extremely small sample size.

There are a couple of threads that may help get some background info on other FOTO (Five-On, Two-Off) or short schedules, as the concept isn't new, with some good results and mixed results.

Can HIV Treatment Be Taken Just 4 Days a Week?
https://forums.poz.com/index.php?topic=75216.msg

French study only taking ART 4 days a week
http://i-base.info/htb/36517

FOTO: https://www.poz.com/article/hiv-efavirenz-intermittent-16959-8019

Thread:
Every Other Day: https://forums.poz.com/index.php?topic=72189.msg

Thread: Newer HIV Regimens May Require Less Strict Adherence
https://forums.poz.com/index.php?topic=73003.0

Thread: Fours days a week
https://forums.poz.com/index.php?topic=72799.msg
https://forums.poz.com/index.php?topic=75216.msg

My doctor refused to change the therapy.

Have you looked into what other "mainstream" (approved) treatment options are available in your region? 

[testii28]

Thanks for this great information's. The doctor didn't give any reason he just said NO and I had to leave. He gave me the feeling that I should be happy to be alive and get treated.
I just want to get rid off this TAF stuff. Dovato, Juluca, and Triumeq is here not available. It is important for me that my therapy includes an Integrase-inhibitor.

Jim, do you think it is a good idea to continue Biktarvy for the next 3 months until my VL is hopefully fully suppressed  and switching then to 5 days on/2 days off? Worth a try? As far as i read in the links you have given developing resistance should not be an issue.

This kidney thing makes me worry because I also have slight pain and I urinate more than usual.

[Jim Allen]

Jim, do you think it is a good idea to continue Biktarvy for the next 3 months until my VL is hopefully fully suppressed  and switching then to 5 days on/2 days off? Worth a try? As far as i read in the links you have given developing resistance should not be an issue.

This kidney thing makes me worry because I also have slight pain and I urinate more than usual.

Look, I'm not even sure why you want to do FOTO, doesn't even matter, as for what I think, nobody cares but, no, I would not recommend anyone start FOTO schedule on their own and certainly not with Biktarvy.

You mention there are not many treatment options where you are, I don't know what is available in your region, I would need to check. But if true and it was me, I would be even more hesitant to mess about.

If it were me, I would see what the kidney function is next time round, and if it's similar levels or improved by then, as you are still settling into treatment; happy days. If it gets dramatically worse, I would have another discussion with the doctor about what alternative treatments are available and to check if there are no underlying conditions.

But that's just me, it's your life, choice and HIV treatment.

[Jim Allen]

I also have slight pain and I urinate more than usual.

Sorry to hear about the pain, pain when pissing? Might be worth seeing a regular GP

[testii28]

I will do as you said. If similar or improved levels I will continue normal,  if rapidly getting worse I will leave to my home country for a few weeks and getting appropriate treatment. I think I still have enough time hopefully.

Thanks Jim

[harleymc]

TAF has never been shown to put pressure on Kidneys. I'm not sure how you leapt to the conclusion you have

[daveR]

My creatinine levels crept up slowly over a period of 5 years on TDF, the switch to TAF made no difference. The switch to Triumeq also did not bring them down too much. They peaked at 1.3 and after the switch to Triumeq for one year are stable at 1.24. My Dr is not bothered. I searched the internet and found many medical sites saying 1.3 for a man is within range and needs no special treatment. The hospital I use has a scale where 1.18 is the maximum. When the Dr checked my pre HIV history we found readings in the past of 1.2 and one of 1.3. No warnings to me. Back then the upper limit was 1.5. It looks as if the experts moved the goal posts sometime after 2012. My Dr is not concerned as long as I have no protein in the urine.

Not sure of your age but problems urinating can be a sign of prostate issues. This can lead to an increase in creatinine according to my Dr as the urine backs up if the bladder is not fully empty. My prostate is enlarged, I have issues urinating. Would be worth consulting a GP if you are getting older, over 50, they may possibly investigate the prostate.