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Author Topic: U = U  (Read 383 times)

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Offline TabooPrincess

  • Member
  • Posts: 314
U = U
« on: August 12, 2021, 03:04:46 pm »
Could someone explain the U = U stuff to me better than my google searches? So I donít have to use condoms now, I get that. But how can we know if we are still undetectable between tests? Iíve tested undetectable for 8 years but occasionally I miss doses or take them late etc. I canít find much to work out how many missed doses would then equate a risk.
Hoping my questioning makes sense
09/ 2008 - Seroconversion
11/2008 - Tested pos, cd4 640 vl 25400
12/2008 - cd4 794 vl 27798, 35%
03/2009 - cd4 844 vl 68846, 35%
06/2009 - cd4 476 vl 49151, 33% (pregnancy confirmed)
08/2009 - cd4 464 vl 54662, 32%
Started meds for pregnancy (Kaletra, AZT, Viread)
09/2009 - cd4 841 vl 3213, 42%
10/2009 - cd4 860 vl 1088, 41%
11/2009 - cd4 771 vl 563, 38%
12/2009 - cd4 885 vl 151 42%
Discontinued meds after baby born
02/2010 - cd4 841 vl 63781, 38%
05/2010 - cd4 1080 vl 113000, 39%
08/2010 - cd4 770 vl 109242
12/2010 - cd4 642 vl 111000, 34%
06/2011 - cd4 450 vl 222000, 33%
11/2011 - cd4 419 vl 212000, 24%
03/2012 - cd4 280 vl 118000, 26% (repeated Cd4 at 360)
05/2012 -cd4 360 vl 99,190
10/2012 Atripla, cd4 690, vl 80
12/2012 Darunavir, norvir, truvada, Cd4 680, vl u/d
07/2013 cd4 750,ud

Offline Jim Allen

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    • HIV Lessons
Re: U = U
« Reply #1 on: August 12, 2021, 03:33:44 pm »
Hiya.

I moved this to prevention as the question relates to TaSP/U=U.

Quote
Iíve tested undetectable for 8 years but occasionally I miss doses or take them late etc.

There is a reason you remain UD, firstly taking the meds a few hours early or late isn't an issue, and adherence is measured by taking your meds 95% of the time. So missing a dose once in a blue moon isn't something to stress about either.

So if your HIV has been suppressed to below 200 copies and keep taking your meds, you should maintain that level of suppression.

Although optimal adherence levels in data & studies have been shown to be way broader than the 90-95% goal, I still think it's still wise to aim to take your meds daily to have that safety margin and a habit of taking them whilst striving to reach at least 95%.

Quote
So I donít have to use condoms now, I get that

Well, you will not pass HIV on sexually, that's correct. Condoms could still be used to reduce the risk for other easier acquire STI's and complications that can arise from having other STI's to treat.

Best, Jim

https://www.poz.com/article/newer-hiv-regimens-may-require-less-strict-adherence

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5943894/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4839839/
Adherence to Antiretroviral Therapy and Virologic Failure

Paterson et al suggested that at least 95% adherence to unboosted PIs was required for virologic suppression. This 95% adherence cut-off point, based on what is now obsolete therapy, has been widely used as the level of optimal adherence needed to be met by patients taking newer agents and their combinations.

https://journals.lww.com/jaids/Abstract/2019/11010/Antiretroviral_Adherence_Level_Necessary_for_HIV.3.aspx

Antiretroviral Adherence Level Necessary for HIV Viral Suppression Using Real-World Data

A benchmark of near-perfect adherence (≥95%) to antiretroviral therapy (ART) is often cited as necessary for HIV viral suppression. However, given newer, more effective ART medications, the threshold for viral suppression may be lower. We estimated the minimum ART adherence level necessary to achieve viral suppression.

Results: The adjusted odds of viral suppression did not differ between persons with an adherence level of 80% to <85% or 85% to <90% and those with an adherence level of ≥90%. In addition, the overall estimated adherence level necessary to achieve viral suppression in 90% of viral load tests was 82% and varied by regimen type; integrase inhibitor- and nonnucleoside reverse transcriptase inhibitor-based regimens achieved 90% viral suppression with adherence levels of 75% and 78%, respectively.
HIV 101 - Everything you need to know
HIV 101
Read more about Testing here:
HIV Testing
Read about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read about HIV prevention here:
HIV prevention
Read about PEP and PrEP here
PEP and PrEP

Offline TabooPrincess

  • Member
  • Posts: 314
Re: U = U
« Reply #2 on: August 12, 2021, 03:38:35 pm »
Thanks Jim
I think unless we can fully get our heads around U=U then the rest of the population will definitely struggle.
Appreciate the quick response
09/ 2008 - Seroconversion
11/2008 - Tested pos, cd4 640 vl 25400
12/2008 - cd4 794 vl 27798, 35%
03/2009 - cd4 844 vl 68846, 35%
06/2009 - cd4 476 vl 49151, 33% (pregnancy confirmed)
08/2009 - cd4 464 vl 54662, 32%
Started meds for pregnancy (Kaletra, AZT, Viread)
09/2009 - cd4 841 vl 3213, 42%
10/2009 - cd4 860 vl 1088, 41%
11/2009 - cd4 771 vl 563, 38%
12/2009 - cd4 885 vl 151 42%
Discontinued meds after baby born
02/2010 - cd4 841 vl 63781, 38%
05/2010 - cd4 1080 vl 113000, 39%
08/2010 - cd4 770 vl 109242
12/2010 - cd4 642 vl 111000, 34%
06/2011 - cd4 450 vl 222000, 33%
11/2011 - cd4 419 vl 212000, 24%
03/2012 - cd4 280 vl 118000, 26% (repeated Cd4 at 360)
05/2012 -cd4 360 vl 99,190
10/2012 Atripla, cd4 690, vl 80
12/2012 Darunavir, norvir, truvada, Cd4 680, vl u/d
07/2013 cd4 750,ud

Offline Jim Allen

  • Administrator
  • Member
  • Posts: 18,044
  • Twitter @JimAllenDublin
    • HIV Lessons
Re: U = U
« Reply #3 on: August 12, 2021, 03:41:37 pm »
You're welcome.

My own experience from explaining it one-to-one and also at events is people with an open mind understand TaSP/U=U very well when it's explained correctly and they can ask questions.

Although, some people will never want or be interested in understanding it.
HIV 101 - Everything you need to know
HIV 101
Read more about Testing here:
HIV Testing
Read about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read about HIV prevention here:
HIV prevention
Read about PEP and PrEP here
PEP and PrEP

 


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