HIV regimen question

[christophersf1964]

Hello,

I've been living with HIV for 20 years. I've been on one treatment regimen since being diagnosed. I remain undetectable and my CD4 count has ranged between 862 and 591 over the last few years.

I began treatment within weeks of being exposed to HIV. I take Reyatez and Epzicom, which consist of three pills once a day. I have had no side effects since I started treatment.

While this regimen is working well, I worry about the cumulative toxicity burden these older drugs are having on my system. I'm thinking about going on a newer treatment regimen with one pill in hopes of mitigating some of this.

Would love to get some thoughts from others on this topic.

Thank you.

Christopher

[Jim Allen]

Hiya,

Have you spoken to your healthcare provider about switching already? Did they recommend any particular option?

Unless there is a problem with the labs, I would not change. I have refused to change my current HIV treatment choice for this reason, nothing wrong with it, and there is no benefit for me to change. 

If you do change, you could get newer combinations without the Atazanavir (Reyatez), although many options would still contain Abacavir or lamivudine.  (Epzicom)

Another option would be one pill a day combined with TAF like Biktarvy (Bictegravir + emtricitabine + tenofovir alafenamide) Although some people have issues like weight gain.

https://www.poz.com/drug_charts/hiv-drug-chart

I'm taking Triumeq (Dolutegravir + Lamivudine + Abacavir), so one pill a day, and I don't need to take it with food; I have no complaints but Dolutegravir isn't everyone's cup of tea. There are also combinations that only use two drugs nowadays, like Dovato (Dolutegravir/Lamivudine )

Your choice would also depend on your other medical needs, your resistance profile, and what could work for you.

Have a look at the drug chat and talk to your doctor.

[christophersf1964]

Thanks for sharing your thoughts, Jim.

I have spoken to my physician about changing meds. He's open to letting me switch to one pill a day and suggested Biktarvy.

There are no problems with my labs, and I'm a healthy guy with no other medical problems.

The more I research switching, the more inclined I am to stick with the medication that I'm on. You run the risk of side effects and there's a chance I might be resistant to the new meds.

One other reason I was thinking about changing meds is because of my sleep. I wake up a lot at night and have wondered if it had anything to do with the meds I'm on.

Christopher

[Tonny2]

               ojo.                 Hi Christopher, definitely, you are taking and no regiment. I took Reyataz in 2006, he didn’t work for me. I guess it’s time to try a new medication, just one pill a day. Biktarvy is good medication, I have lots of friends, taking it without a problem, hopefully you will be happy with the change… wishing you the best and please keep us posted
Hugs

[christophersf1964]

Thank you, Tonny2.

Christopher

[leatherman]

toxicity

just a pet peeve of mine, but this stigma surrounding HIV meds always gets me.

HIV meds simply stop HIV from replicating. They don't make you lose your hair or destroy parts of your immune system, etc like other meds. Now some of these meds don't always flush through the kidneys well and that can be a problem; but that's really not the med but somebody's kidneys and how their body functions. In cases like that, you just try a different regimen. Reading the package inserts and the FDA approvals, it's easy to see that most people have no long term or short term effects. Some people do have short term effects for a while and only a tiny percentage of patients have long term effects. The end result is that most people have no effects except for the suppression of HIV.

There is really no toxicity with HIV meds. There's just how your body handles or doesn't handle them.

That's why, getting back to your question, my advice as someone who's been taking meds for 3 decades, is if it ain't broke don't fix it.

[christophersf1964]

Thanks for sharing your perspective, Leatherman.

Christopher

[Grasshopper]

just a pet peeve of mine, but this stigma surrounding HIV meds always gets me.



That's why, getting back to your question, my advice as someone who's been taking meds for 3 decades, is if it ain't broke don't fix it.

Gets on my nerves too when reading such comments.
Totally agree with your last sentence .

I've been on Biktarvy (without any issues) for the last couple of years. Undetectable since 2001 with excellent CD4 count (mind you coming from a Nadir of 0= zero!)...a bit reluctant to say how many. The "excellent CD4 count" 4 times in a row however was a bit of a concern for my doc's, so I had extra labs done to exclude possible Leukemia. But thank Heavens those came back negative. For years I was hovering around 1300 CD4's, but the last 4 labs I had counts averaging 1900 CD4's.

The pains and aches that I have once in a very while, are age related......Hiv/Aids feels to me like something from a previous life.

[Charles.M]

Gets on my nerves too when reading such comments.
Totally agree with your last sentence .

I've been on Biktarvy (without any issues) for the last couple of years. Undetectable since 2001 with excellent CD4 count (mind you coming from a Nadir of 0= zero!)...a bit reluctant to say how many. The "excellent CD4 count" 4 times in a row however was a bit of a concern for my doc's, so I had extra labs done to exclude possible Leukemia. But thank Heavens those came back negative. For years I was hovering around 1300 CD4's, but the last 4 labs I had counts averaging 1900 CD4's.

The pains and aches that I have once in a very while, are age related......Hiv/Aids feels to me like something from a previous life.

So you been living with this for twenty plus years? Did I understand your comment correctly your initial CD4 count was zero none at all?