Switching from Kaletra Truvada To Reyataz/Tuvada/Norvir

[marsss7080]

Hello To All Of You,
I haven't been this website in about 2 years. I was diagnosed in '07 and was placed on Kaletra/Truvada/Dapson. Stats at the time were Viral - 750k+, CD4 - 2. After fighting many OI's, an allergic reaction to bactrim and wasting away 30lbs and going through 5 weeks of pure hell with the meds I am still not making the progress I want and dealing with side effects.

My 07/2009 stats currently are; Viral - Undect., CD4 - 150. After firing my previous HIV physician for, poor bedsode mannerism and language that was not necessary towards me I switched and now have have a new doc.
We just tried the Atripla route. Forget it! The side effects were awefull. Dizziness, nausea, vomiting, high anxiety etc. That's after just 3 days. I stopped and went back to Kaletra and Truvada

He is now going to place me on Reyataz/Truvada/Norvir. My question is will my CD4 go up as he suggests and wants or will I be hovering in the 150's. He suggests to hit it hard with all three and see where it goes with the CD4.  He also said that i could have permanently damaged my chances for a higher CD4 count as i started at 2 to begin with. I am willing to try but awful sceptical with the side effects from the Kaletra/Truvda that was 5 weeks and then trying to switch to Atripla and that was a disaster for three days with more horrifying side effects. I begin to wonder if this is what my life has become nothing but side effects.  I have heard of horror stories, jaundice, yellowing, joint pain, nausea, etc. etc. Then I here the flip side it's great, no side effects, counts go up, viral goes down hurray!

Any thoughts or suggestions or comments are all welcomed. Is there a better once a day hi boosting CD4 regime that would work better or equal too? I have had the genotype and am NOT resistant to any meds so the slate is clean. Hurray! Well I start in two weeks after I see him and he prescribes this new regime.[/font]

[jay195]

Hi M ! I am sorry to hear you have had such a bad time.I too started off on Kaletra and Truvada .CDs 247 and VL 5 thousand and something.  I was on that combo for three months . The only side affect was the awful diarrhea and gas . My cds went up and the V.L. went down. I have been on Truvada,Norvir and Reyataz for the last nine months or so and this combo suits me very well.Absolutely no side affects whatsoever.CDs 750 and VL undetectable. I was informed of the possible side affects at the hospital and I was so scared and upset that I started to cry.I remeber looking at the meds  before I took them for the first time and wondering how I'd feel after taking them , but I was fine. I was waiting to get  dizzy or start throwing up or something but it was a breeze.Everyone reacts differently and I think a lot of it is in our heads . So don't worry because you are going to be just fine.     
                                                   Jay xx

[Inchlingblue]

You are already on Truvada so you are basically switching out Kaletra for Reyataz/Norvir. As Jay said, everyone reacts differently but there is a very good chance that you will be fine. Some people do get the yellowing of the eyes but most of the time that goes away. I heard that drinking lots of water helps minimize it.

The important thing is that you are adherent so you can remain undetectable, that way if you want to try a different combo you can always do that without getting resistance.

Isentress is excellent but it is twice a day for now. I am on it and I'm not experiencing any side effects whatsoever. In the near future it's likely to be approved for once daily dosing.

There are some very promising studies using IL-7 to boost CD4s. For now, they are in the early stages but it's possible that it could work in boosting CD4s, so it's something to keep in mind for the future (unless you want to check out the clinical trials, which is also an option).

LINK:

http://www.medicalnewstoday.com/articles/142567.php

[BM]

With regards jaundice, I experienced quite a definite yellowing at the start that has since faded. It's now only noticeable in bright light (and even then it's a very slight discolouration). My eyes are yellow only in those areas that are covered by skin. These considerations aside, Reyataz is a great drug that's unique among protease inhibitors in that it's very cholesterol friendly (and dosed once-a-day).

As far as I'm aware, all that can be expected of the antiretroviral drugs is to reduce viral load: gains in CD4 are dependent upon the body repairing itself from the sustained viral attack. I've heard a few stories of people such as yourself, starting out with very low CD4 counts who make some gains on therapy, then plateau for a long time at a disappointing CD4 level, only to go on to make large gains in a relatively short space of time (perhaps these people could comment?).

[bluewater]

Hello am newly diagnosed and on atrpila am having trouble emotionally it seems i get very anxious and depressed, it seems i cannot handle stress at all any more is this common and should i consider SSRI's again i was on celelxa.

[risred1]

bluewater - suggest you start your own thread if you have a question you would like the community to address... in essence, this is called thread hijacking...


marsss -

I started treatment this summer and am on Truvada/Reyataz/Norvir.

1) You need to have a booster, Norvir as part of your regimen. Kaletra already has Novir as part of the formula. With Truvada, one should boost reyataz. My doc and I almost made the mistake of not boosting. This board, thank goodness spotted the error.

2) Reyataz generally has a more favorable side effect profile compare to Kaletra when it comes to diarrhea and lipids. And is considered to be as effective.

3) The side effect raising your bilibrium, which may cause eyes to yellow or skin to yellow, isn't a common side effect, but there are some to whom this does happen. Sometimes it passes.

4) Regardless of the ARV med, there usually is an adjustment period. During this period, which i would say could be up to three weeks, you might experience, headaches, strange surges of energy and fatigue, digestive effects, yellowing, etc. For me, it was headaches and gas as the most noticible ones, and a slight rash which took about 3 weeks to pass. Since you are changing just the PI part of the combo, if may not be that significant. But I had to add Norvir after week two, and I had to go through another week of adjustment.

5) I would say I'm pretty much side effect free after 4 months, and doing better. There are things that affect me though, from caffiene and pot, which i'm evaluating what my relationship to them should be. I also take Psyllium Fiber in a daily Drink to help my digestion with Yogurt and some glutamine, which really helps the digestive track work well.

PI based regimens are slightly better from a Immunicological aspect, than Atripla which is better viralogically. What this means it, PI tend to boost CD4 counts faster than Atripla, which is deemed better at controlling Viral Load. Since your working to rebuild your CD4, PI is probably the better treatment path.

I wrote a LOG about my experience in starting my med program Which is about Reyataz, Truvada Norvir Combo and its posted in this forum.  Pretty much a daily diary and now I periodically update it after blood tests.

Lastly on your CD4 recovery. These things take time. And sometimes it may not improve much from where you are. Its not so much a function, from what studies show, about your CD4 dropping so low, as it is a function of your lymphatic system. Some lymph systems are damaged by HIV more significantly and some are not. That damage often can limit how far your CD4's can recover.

Not so say there may be no options, such as InterLukin, or even a selenium supplement and some anti inflamatories which may help. But I don't know what the long term implications are of these activities, so working with your doctor is probably the best option, and doing research on the subject and of course asking the board for help.

[Erico]

Hi M,

I had to start meds one year ago and, as usual, my doctor wanted me to take atripla. Since I knew a couple of people who had a very very hard time with the sustiva component, I opted for the Truvada/Reyataz/Norvir option, which was obviously a good idea : I've been on it for a year now and didn't experience (or notice) any side effects.  Nada. I know several people who take it too and none of them seems to have problems with it. As far as I know this is one of the best combos available as far as long and short term side effects are concerned.

Erico

[BlueMoon]

Boosted Reyataz with Truvada has been very easy on me.  The only noticeable side effect is occasional yellowing, which seems to be brought on by use of poppers.  Others have said that alcohol use does it.  You might also want to read the thread in this section about marijuana and tobacco and Reyataz.

I think that CD4 recovery is more a function of virus suppression and individual constitution, rather than any specific medication.  The important thing is that you be on a tolerable regimen you can adhere to.

[weasel]

Hey Marsss   ,
                        I have been POS for  25 plus years !


            I started  Reyataz , truvada ,Novir    5 years ago !

   My    T cells were   101  at the time !  

           Viral  was  365,000 ??

  It took  two months to drop to undetectable and    a  few years  for my  T cells to return to normal !

  I find if I eat well (   no crap , sugar ,soda ,beef  etc. )   that  I  have  very few side effects !

                               Wishing you well on your new   regime

                                                                      Carl


P.S.  I started  MEDS at age  50  

[leezaa]

I got an allergic reaction to either the rayataz or the norvir.....Im on the kaleetra and truvada right now.and yeah i have the diarhea and gas, its been a pretty easy transition from what i was taking.. im ambivalent about the atripla because of the past results with sustiva. but good luck to you

[jay195]

It's hard to say how your cds are going to react as nobody ( normally ) has a baseline to go by.

 Jay xx