Weird doctors advice....

[jimmydenver]

I have had HIV about 4 year, started meds (kaletra and combivir) about 2 months ago.  Side note: The diarrhea is great, lol, lots of reading time!

My gf has been on meds about 3 years.  She was very insistent when I started that I take them each day at the specified time, very little tolerance for being late.

Now, my doc when I asked him recently, he said it didnt matter, I could be late 6 hours, no big deal.  My gf totally disagreed with him using her knowledge from her docs (she is w/state clinic, I get care through VA).

Any advice on this?  I am inclined to believe her because shes had 4 diff doctors over her last 4 years, and all said the same thing.  Plus my VA doc seems flaky at best.

Thanks

[mecch]

(better advice below...) 

[newt]

I think your doc is probably technically right for nearly all people on this combo. Kaletra is  often  used once a day now for a start. Little nervous about +6 hours on the AZT in Combivir though.

But I do have to ask, why are you still on the Combivir, and why on this old combo at all given there are newer ones that allow you to go out without a portable toilet in tow?

- matt

[jimmydenver]

Combo, I dont know...the woman thought the same thing, one has AZT in it, so was dumbfounded why I would be on these too.

My numbers CD4 over the course of about 2 years w/o meds went from about 650 to 530, viral load is always through the root, usually about 80000-100000.

The other odd part, is I saw him Friday, after 2 months on my previous meds, w/o having my new bloodwork back, he changed me to new ones starting tomorrow.  I will post the new ones tomorrow, I should know them but I do not.

[buginme2]

Why are you on this combo? Why isn't your doctor following US treatment guidelines? I assume you are in Denver right?

Is it due to resistance issues? What did your genotype test reveal?

I vote for a second opinion

[jimmydenver]

No, I am in Vegas.

So I got the results back, my CD4 was 505 and viral load 106,000 (approximate) 3 months ago, my viral load has always been high.   The new results are CD4 530 and viral load at 58 (yes, just 58). 
From label:
Emtricitabine
Norvir
and Reyataz

I started them about 5 days ago, no odd effects yet.

[newt]

Okay, good, better, but now you are on a cut-down (non-guideline compliant) combo. Guidelines recommend 1 extra drug with Reyataz/Norvir.

This don't matter if your viral load goes and stays below 40, for the proof of the pudding is suppressed viral load, not how many drugs you take.

- matt

[mdpoz06]

Hey Jimmy...
I'm late to this post but wanted to give some input regarding your diarrhea: I'm also on Kaletra, along with Trizivir, viread, 7 years but for a 6 mo. break when I didn't have insurance. 

Anyway, Kaletra gives me prtty bad D also, but I started taking a low dose multo-enzyme pro-biotic every (1 billion acu's). One a day in the morning on an empty stomach works wonders.  Before that I had to take to immodium-D every morning. It was a relief to get back to normal bm's.  Good luck!

[songs06]

I heard lots of stuff about Kaletra, it seems like it does gastrointestinal side effects %25 of the people. but i didn't get any diarrhea or vomiting at all. just mild nausea and it has gone in 15 days. just a little tiredness and depression now