How long will I live?

[Andy@Sef]

Hi Everyone,

I have been diagnosed with HIV last year and immediately seek medical attention when I found out. I've had a CD4 count of 324 at that time but haven't done any viral load testing.  My Doctor immediately started my ART. It's been almost a year since then and I have undergone 2 complicated  surgical operation this year, I had appendectomy last Feb 2017 and a right hemicolectomy last August 2017. The later procedure was due to the infection that occurs at the site where my appendix was removed.

I need to stop my ART for about 2 weeks for both procedures that I mentioned, 1 week before and another 1 week after the operation since that was the instruction of my surgeon.

My CD4 went down from 324 to 104 in just about 1 year and I was very worried if I'm getting drug resistance to Atripla. My Doctor ordered a viral load test and she's waiting for the result. What should I do now? I'm really depressed with my situation.. I haven't had any opportunistic infection since I was diagnosed. Please help me.

Thanks for your time
Andy

[Jim Allen]

Hi

So sorry to hear about the appendix issues. I had mine out in 2011.

If I understand correctly you stopped your meds for 2 weeks, you are back on treatment but you have never had a VL test done and you are concerned if the treatment is still working.

The thing is if you never had a VL done before than you have no way of knowing if the medication was working for you and if you had no resistance testing done than you have no way of knowing if your hiv was resistant to begin with.

Look best thing is to get the VL test done as that is one of the most important things to know and ask your doctor about resistance if your VL is not undetectable.

If and that is a big if, your hiv is resistant to the treatment you are on its not the end of the world, but it does mean you will need a different medication for treatment.

I wish I could write more but I'm on my way into the office, I will check back with you later.

Jim

[harleymc]

Surgeons don't have any expertise in medications, they are cutters not medicators.  My Infectious disease doctor has never recommended going off medications for surgery.

Have a talk to your doctor about whether there is any issue with continuing on medications before and after surgery.

[leatherman]

My Infectious disease doctor has never recommended going off medications for surgery.

my surgeons have never, in 26 yrs of meds and through nearly a dozen surgeries, suggested I stop antiretrovirals for any reason. I can't imagine that any surgery would require such a change. However, I would point out that there are some anesthesias that should not be used with certain antiretrovirals. In these cases, the solution is to change the anesthesia.

Stopping antiretrovirals for 2 weeks is asking for the trouble of resistance....although that happening would not be a certainty. You would definitely need viral load testing (and perhaps a resistance/genotype test) done to determine that

I'm really depressed with my situation

don't get too down   the solution is easy - get on another regimen of medications. There are other options available (and often, depending on your location, Atripla isn't even the preferred regimen anymore).

[Tonny2]

      ojo        Hello Andy...I'm sorry for the low cd4, let's see what the viral load says...Can we know where  you are from, i
this depends if you will be able to get a resistance test )I know some countries just give you the meds and wait and see if they work)...do not be depress, if you were to be resistance to atripla, I'm sure you will get a differen treatment, so, hang in there and keep us posted...hugs                                                                                ojo