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Author Topic: Starting treatment advice pls  (Read 5202 times)

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Offline Dundeelad

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  • Posts: 16
Starting treatment advice pls
« on: April 21, 2014, 11:13:02 am »
Hi folks

Cd4 has always hovered around 480 mark with cd4 % of around 27. Latest results, cd4 the same but percentage had dropped to 21%. Thinking of starting treatment on my next visit, and due to working shifts I think atripla is going to be my best first choice due to not requiring any food but also the convenience of a one pill combo.

Anyone any thoughts/advice/tips/experience?
Diagnosed Feb 2013 CD4 460 VL 34000
Then CD4 has went to 480, 470, 360, 470, 690 all prior to treatment.
Latest VL 42000

Offline mikeyb39

  • Member
  • Posts: 980
Re: Starting treatment advice pls
« Reply #1 on: April 21, 2014, 04:02:25 pm »
If you can handle the CNS side effects then prob worth a try. I atarted out on it and stayed on for 8 months, but it did a number on me so i cant reccommend it myself but some are ok with it
11/02/2010  cd4-251, vl-591000
12/09/2010  started Atripla
02/18/2011  cd4-425, vl-800
06/10/2011  cd4-447, vl-70
10/10/2011  cd4-666, vl-80
01/05/2012  swiched med (prezista,norvir ,isentress, )
02/10/2012  cd4-733, vl-UD  Viread removed
06/10/2012  cd4-614, vl-UD
12/14/2012  cd4-764, vl-UD
09/01/2013  cd4-785, vl-UD
03/06/2014. cd4- 1078, VL-UD
09/05/2014  cd4-850 , VL-UD
09/05/2014 switched meds isentress, prezcobix -still only two antivirals
10/14/2015  cd4-600 , VL-UD

Offline Dundeelad

  • Member
  • Posts: 16
Re: Starting treatment advice pls
« Reply #2 on: April 21, 2014, 04:35:30 pm »
Is it recommended as a first line approach? I'm petrified of any form of side effects... but I know its going to be a risk with any type of med I guess.  I think I just like this one for fitting it in with my current lifestyle...
Diagnosed Feb 2013 CD4 460 VL 34000
Then CD4 has went to 480, 470, 360, 470, 690 all prior to treatment.
Latest VL 42000

Offline Dundeelad

  • Member
  • Posts: 16
Re: Starting treatment advice pls
« Reply #3 on: April 21, 2014, 06:03:46 pm »
Anyone else?
Diagnosed Feb 2013 CD4 460 VL 34000
Then CD4 has went to 480, 470, 360, 470, 690 all prior to treatment.
Latest VL 42000

Offline BT65

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  • Posts: 10,786
Re: Starting treatment advice pls
« Reply #4 on: April 21, 2014, 07:44:30 pm »
Have you had any issues with depression?  If so, Atripla would not be for you.  There is also Complera and Stribild.  They're both once a day. 
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Offline mecch

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  • Posts: 13,455
  • red pill? or blue pill?
Re: Starting treatment advice pls
« Reply #5 on: April 21, 2014, 07:50:23 pm »
Hi folks

Cd4 has always hovered around 480 mark with cd4 % of around 27. Latest results, cd4 the same but percentage had dropped to 21%. Thinking of starting treatment on my next visit, and due to working shifts I think atripla is going to be my best first choice due to not requiring any food but also the convenience of a one pill combo.

Anyone any thoughts/advice/tips/experience?

If you have a choice of combos, Atripla would not be the first pick.  Complera, srtribild, isentress and truvada.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Jeff G

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  • How am I doing Beren ?
Re: Starting treatment advice pls
« Reply #6 on: April 21, 2014, 08:13:32 pm »
I agree with Betty and Mecch .
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Offline newt

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  • the one and original newt
Re: Starting treatment advice pls
« Reply #7 on: April 22, 2014, 06:26:09 am »
Atripla, specifically efavirenz, is not idea for shift work pattern. There are some folk who find it fine, but the point of taking the tabs at night is so you are asleep when the efavirenz is making your brain whizz and balance go off. Me personally, I'd want something else, 1 x day, forgiving on timing, minimal/no food restriction - matt
"The object is to be a well patient, not a good patient"

Offline zach

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  • Posts: 3,586
Re: Starting treatment advice pls
« Reply #8 on: April 22, 2014, 07:06:57 am »
Yes, it is considered first line almost gold standard. Its almost the go to these days. There are also a couple other one pill a day combos, as well as two/three pills once a day, which is little different to me.

If you have had any mental health issues in your past, proceed with extreme caution. They seem to come back, with a vengeance. Other than the CNS side effects the results the med gets are awesome. You will be UD in short order.

Side effects are no reason to fear treatment, if you experience them, if they are really present, talk to your doctor about a med change. There are many options.

Newt is also correct, I was no longer able to work a rotating shift. I was no longer able to switch easily between day/night sleeping.

Offline Jmarksto

  • Member
  • Posts: 667
Re: Starting treatment advice pls
« Reply #9 on: April 22, 2014, 10:05:28 am »
Dundee;  I am on Complera, which meets most of Newt's suggestions but does require 400 calories, which hasn't been hard for me at all.   

Regarding side effects - keep in mind that very few people get side effects, and if they do they diminish relatively quickly (within a week or so).  As you read through the boards here on the different regimens please keep in mind that people are more likely to post if they have problems.

I wish you the best,
JM
03/15/12 Negative
06/15/12 Positive
07/11/12 CD4 790          VL 4,000
08/06/12 CD4 816/38%   VL 49,300
08/20/12 Started Complera
11/06/12 CD4   819/41% VL 38
02/11/13 CD4   935/41% VL UD
06/06/13 CD4   816/41% VL UD
10/28/13 CD4 1131/45% VL 25
02/25/14 CD4   792/37% VL UD
07/09/14 CD4 1004/39% VL UD
11/03/14 CD4   711/34% VL UD
03/13/15 CD4   833/36% VL UD
04/??/15 Truvada & Tivicay
06/01/15 CD4 1100/50% VL UD
10/16/15 CD4   826/43% VL UD
??/??/2017 Descov & Tivicay
2017 VL UD, CD4 stable around 850
2018 VL UD, CD4 stable around 850

Offline eric48

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  • Posts: 1,361
Re: Starting treatment advice pls
« Reply #10 on: April 22, 2014, 10:46:38 am »
Hi,

If I remember correctly Ray, a Viramune/Kivexa user was working nightshifts

There is no food requirements with Viramune and commonly associated backbones

Moreover, you have the flexibility of taking 400 mg once a day or 200 mg twice a day

Which I find convinient for intercontinental travelling (time difference)

Viramune causes CNS effects in 1% patient (compared to 10%) in EFV (containing regimen) . Taking the CNS offending drug as twice daily (versus once daily) may reduce CNS effects

If you are in fear that you may miss one day dosing because of your schedule, then a drug with a long half time would be preferred

For backbones: Truvada has a longer half life than Kivexa (if my memory is correct)

For the third drug , half life of Viramune and Efavirenz are very long. For other NNRTIs and other IIs , you will have to look them up

Hope this helps

Eric
NVP/ABC/3TC/... UD ; CD4 > 900; CD4/CD8 ~ 1.5   stock : 6 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: Clin. Trial NCT02157311 = 4days ON, 3days OFF ; 2015: https://clinicaltrials.gov/ct2/show/NCT02157311 ; 2016: use of granted patent US9101633, 3 days ON, 4days OFF; 2017: added TDF, so NVP/TDF/ABC/3TC, once weekly

Offline Dundeelad

  • Member
  • Posts: 16
Re: Starting treatment advice pls
« Reply #11 on: April 22, 2014, 02:28:03 pm »
My shifts don't involve night shifts. But they range from 6am-2pm, 10-6, and 2-10. All day shifts... But as you can imagine my times of eating in these varies greatly. That's why I thought atripla sounded perfect. 10pm nightly... Boom. Then sleep. lol.
Diagnosed Feb 2013 CD4 460 VL 34000
Then CD4 has went to 480, 470, 360, 470, 690 all prior to treatment.
Latest VL 42000

Offline zach

  • Member
  • Posts: 3,586
Re: Starting treatment advice pls
« Reply #12 on: April 22, 2014, 03:05:38 pm »
your plan is sound. no need for worry. i'd say jump in headfirst, thats just me

in my experience there are only two concerns with atripla. preexisting serious mental health issues which may return. and sleep can be an issue, but is more than manageable

you sound like you've thought this out well, and only need reassurance. be assured, serious side effects are rare. for most, atripla is well tolerated and effective

good luck, hang around, and let us know how things develop

Offline Dundeelad

  • Member
  • Posts: 16
Re: Starting treatment advice pls
« Reply #13 on: April 22, 2014, 04:37:38 pm »
Cheers zack.

Yeah I think it's reassurance I need haha. It's weird going through something like
This on your own with none of your friends able to sorta chip in. Or they can, but they don't understand. So online folk are the only people I really have to talk it through with.  I'll mention my thoughts and some of the points you
Guys have made to
My
Doc and see what he suggests. Thanks everyone! Been greatly appreciated
Diagnosed Feb 2013 CD4 460 VL 34000
Then CD4 has went to 480, 470, 360, 470, 690 all prior to treatment.
Latest VL 42000

 


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