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Author Topic: Went off in a huff...  (Read 6120 times)

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Offline leese43

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  • Posts: 257
Went off in a huff...
« on: July 25, 2010, 06:38:36 am »
...then got sick so not been around for quite some time. Well, I have but just reading as a guest.

Have had a horrible 6 weeks of fever, nausea and fatigue. On a positive note I've lost 25lbs in the process. Anyway, seems it's time for meds. I have a doc's appointment to discuss options on Wednesday and so thought I'd ask you for some tips. I'm resistant to NNRTI's so with the research I've done myself I'm thinking Reyataz/Truvada/Norvir. Are there other combi's I should be thinking about?

 
Oct 04 - Neg
Aug 05 - infected
Oct 05 - cd4 780, vl 60k
Apr 08 - cd4 430, vl 243
Jul 08 - cd4 550, vl 896
Nov 08 - cd4 730, vl 1.8k
May 09 - cd4 590, vl 1.5k
Sep 09 - cd4 460 vl 34k
Dec 09 - cd4 470 vl 42k
April 10 - cd4 430 vl 88.5k
July 10 - cd4 330 vl 118k
Aug 10 - started reyataz/truvada/norvir
Aug 10 - cd4 380 vl 4k (12 days after starting meds :))
Sep 10 - cd4 520 vl 1.5k
Oct 10 - cd4 590 vl 44
Jan 11 -cd4 610 vl <40 cd4% 50
May 11 - cd4 780 vl UD

Offline newt

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  • the one and original newt
Re: Went off in a huff...
« Reply #1 on: July 25, 2010, 07:44:32 am »
Hello again

Prezista (+ Norvir booster) or Isentress, both with Truvada, are other straightforward options. If your viral load is 100,000 or over I personally just now would go with Reyataz or Prezista to start with.

- matt
"The object is to be a well patient, not a good patient"

Offline leese43

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  • Posts: 257
Re: Went off in a huff...
« Reply #2 on: July 25, 2010, 08:25:14 am »
Hello again

Prezista (+ Norvir booster) or Isentress, both with Truvada, are other straightforward options. If your viral load is 100,000 or over I personally just now would go with Reyataz or Prezista to start with.

- matt


Thanks Matt, I will go armed with this too and see what the doc says. I did ask about Isentress but she said that it's not currently used as first line in the UK.

Leese
Oct 04 - Neg
Aug 05 - infected
Oct 05 - cd4 780, vl 60k
Apr 08 - cd4 430, vl 243
Jul 08 - cd4 550, vl 896
Nov 08 - cd4 730, vl 1.8k
May 09 - cd4 590, vl 1.5k
Sep 09 - cd4 460 vl 34k
Dec 09 - cd4 470 vl 42k
April 10 - cd4 430 vl 88.5k
July 10 - cd4 330 vl 118k
Aug 10 - started reyataz/truvada/norvir
Aug 10 - cd4 380 vl 4k (12 days after starting meds :))
Sep 10 - cd4 520 vl 1.5k
Oct 10 - cd4 590 vl 44
Jan 11 -cd4 610 vl <40 cd4% 50
May 11 - cd4 780 vl UD

Offline Ann

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  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: Went off in a huff...
« Reply #3 on: July 25, 2010, 09:09:47 am »
Hi Leese, good to see you around the place again.

Your doctor is wrong about raltegravir (aka Isentress) in treatment naive adults. It was approved for treatment naive use in September 2009.

EU approval

UK approval

edited for clarity
« Last Edit: July 25, 2010, 09:13:10 am by Ann »
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline leese43

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  • Posts: 257
Re: Went off in a huff...
« Reply #4 on: July 25, 2010, 09:19:31 am »
Hi Leese, good to see you around the place again.

Your doctor is wrong about raltegravir in treatment naive adults. It was approved for treatment naive use in September 2009.

[

Thanks Ann.

I did wonder if she's not quite up to scratch on the meds, when I mentioned it she hadn't heard of Isentress and had to look it up in her book.

Can't fault her on anything else though, I've had every test under the sun to make sure I dont have any underlying problems due to the sickness. She's a locum and I get my regular doc back in September, if I come away unhappy with what she prescribes I may hold out a month and see what my doc says.

Leese
Oct 04 - Neg
Aug 05 - infected
Oct 05 - cd4 780, vl 60k
Apr 08 - cd4 430, vl 243
Jul 08 - cd4 550, vl 896
Nov 08 - cd4 730, vl 1.8k
May 09 - cd4 590, vl 1.5k
Sep 09 - cd4 460 vl 34k
Dec 09 - cd4 470 vl 42k
April 10 - cd4 430 vl 88.5k
July 10 - cd4 330 vl 118k
Aug 10 - started reyataz/truvada/norvir
Aug 10 - cd4 380 vl 4k (12 days after starting meds :))
Sep 10 - cd4 520 vl 1.5k
Oct 10 - cd4 590 vl 44
Jan 11 -cd4 610 vl <40 cd4% 50
May 11 - cd4 780 vl UD

Offline newt

  • Member
  • Posts: 3,900
  • the one and original newt
Re: Went off in a huff...
« Reply #5 on: July 25, 2010, 09:20:33 am »
...but most clinics are unliklely to offer it as a first-time option unless you have resistance or special issues, eg concerns about possible side effects from PIs/NNRTis, because of the cost.

- matt
"The object is to be a well patient, not a good patient"

Offline Ann

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  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: Went off in a huff...
« Reply #6 on: July 25, 2010, 09:23:09 am »
...but most clinics are unliklely to offer it as a first-time option unless you have resistance or special issues, eg concerns about possible side effects from PIs/NNRTis, because of the cost.

- matt


Leese IS resistant to NNRTIs - that's why I brought it up that Isentress IS available to her.
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline newt

  • Member
  • Posts: 3,900
  • the one and original newt
Re: Went off in a huff...
« Reply #7 on: July 25, 2010, 09:41:13 am »
Good point, I should pay more attention. It's still a difficult ask tho if you have PI options because in the UK Isentress counts as a "high cost" drug. Probably easier in a large clinic. Good clinical arguments, eg high baseline risk of heart disease may favour Isentress as a choice, but not being once-a-day will count against. Docs seem very keen to start you off on a 1 x day combo.

- matt
"The object is to be a well patient, not a good patient"

Offline leese43

  • Member
  • Posts: 257
Re: Went off in a huff...
« Reply #8 on: July 25, 2010, 09:53:45 am »
Good point, I should pay more attention. It's still a difficult ask tho if you have PI options because in the UK Isentress counts as a "high cost" drug. Probably easier in a large clinic. Good clinical arguments, eg high baseline risk of heart disease may favour Isentress as a choice, but not being once-a-day will count against. Docs seem very keen to start you off on a 1 x day combo.

- matt


And to be honest I'll probably be better off on a 1 x day combo, I'm not great at remembering to take meds so it's going to be a challenge in itself. Just nice to have the knowledge to hand that you and Ann have given me now.

Oct 04 - Neg
Aug 05 - infected
Oct 05 - cd4 780, vl 60k
Apr 08 - cd4 430, vl 243
Jul 08 - cd4 550, vl 896
Nov 08 - cd4 730, vl 1.8k
May 09 - cd4 590, vl 1.5k
Sep 09 - cd4 460 vl 34k
Dec 09 - cd4 470 vl 42k
April 10 - cd4 430 vl 88.5k
July 10 - cd4 330 vl 118k
Aug 10 - started reyataz/truvada/norvir
Aug 10 - cd4 380 vl 4k (12 days after starting meds :))
Sep 10 - cd4 520 vl 1.5k
Oct 10 - cd4 590 vl 44
Jan 11 -cd4 610 vl <40 cd4% 50
May 11 - cd4 780 vl UD

Offline Ann

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  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: Went off in a huff...
« Reply #9 on: July 25, 2010, 10:08:28 am »
Leese, I know exactly what you mean about once-a-day dosing. I'm crap at taking meds too and while I can pretty much remember to take meds once a day, twice is a struggle.

There are on-going studies looking at once-a-day Isentress dosing and they're looking good so far, but approval has yet to be gained.

Good luck with whatever you choose. :)
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline manc

  • Member
  • Posts: 19
Re: Went off in a huff...
« Reply #10 on: July 25, 2010, 04:47:45 pm »
Hi, I'm in the UK.

I started meds in September last year with Atripla but felt really out of it and came out in a pretty bad rash after a couple of weeks.

My consultant offered Truvada + Reyataz (atazanavir) or Truvada + Isentress (raltegravir) as alternatives. There was no pressure about costs and I went for Truvada and Raltegravir. I wasn't that concerned about taking pills twice a day, but was concerned about stomach problems with Norvir. I haven't looked back, my counts are good. I lost the zombie feeling I had with Atripla and haven't found taking pills twice daily a problem. I guess it depends on your routine.

Best of luck


Offline leese43

  • Member
  • Posts: 257
Re: Went off in a huff...
« Reply #11 on: July 25, 2010, 05:04:00 pm »
Hi, I'm in the UK.

I started meds in September last year with Atripla but felt really out of it and came out in a pretty bad rash after a couple of weeks.

My consultant offered Truvada + Reyataz (atazanavir) or Truvada + Isentress (raltegravir) as alternatives. There was no pressure about costs and I went for Truvada and Raltegravir. I wasn't that concerned about taking pills twice a day, but was concerned about stomach problems with Norvir. I haven't looked back, my counts are good. I lost the zombie feeling I had with Atripla and haven't found taking pills twice daily a problem. I guess it depends on your routine.

Best of luck



Thanks Manc.

Happy to hear that it's all worked out for you, I'm hoping for the same..fingers crossed!
Oct 04 - Neg
Aug 05 - infected
Oct 05 - cd4 780, vl 60k
Apr 08 - cd4 430, vl 243
Jul 08 - cd4 550, vl 896
Nov 08 - cd4 730, vl 1.8k
May 09 - cd4 590, vl 1.5k
Sep 09 - cd4 460 vl 34k
Dec 09 - cd4 470 vl 42k
April 10 - cd4 430 vl 88.5k
July 10 - cd4 330 vl 118k
Aug 10 - started reyataz/truvada/norvir
Aug 10 - cd4 380 vl 4k (12 days after starting meds :))
Sep 10 - cd4 520 vl 1.5k
Oct 10 - cd4 590 vl 44
Jan 11 -cd4 610 vl <40 cd4% 50
May 11 - cd4 780 vl UD

Offline Inchlingblue

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Re: Went off in a huff...
« Reply #12 on: July 25, 2010, 05:08:45 pm »
Dr. Gallant gives his opinion on the pros and cons of each of the preferred combos (U.S.) for starting therapy, LINK:

http://www.hopkins-aids.edu/q_a/patient/recent_questions/lost_on_choosing_medication.html?contentInstanceId=513447&siteId=7151

Offline leese43

  • Member
  • Posts: 257
Re: Went off in a huff...
« Reply #13 on: July 25, 2010, 05:22:46 pm »
Dr. Gallant gives his opinion on the pros and cons of each of the preferred combos (U.S.) for starting therapy, LINK:

http://www.hopkins-aids.edu/q_a/patient/recent_questions/lost_on_choosing_medication.html?contentInstanceId=513447&siteId=7151

Thanks Inchlingblue. Taking into account what's been said here and also reading the pro's and cons I think i'll probably try for the reyataz/truvada/norvir and hope I don't become jaundiced. I can probably tolerate that more than a rash though.

Leese
Oct 04 - Neg
Aug 05 - infected
Oct 05 - cd4 780, vl 60k
Apr 08 - cd4 430, vl 243
Jul 08 - cd4 550, vl 896
Nov 08 - cd4 730, vl 1.8k
May 09 - cd4 590, vl 1.5k
Sep 09 - cd4 460 vl 34k
Dec 09 - cd4 470 vl 42k
April 10 - cd4 430 vl 88.5k
July 10 - cd4 330 vl 118k
Aug 10 - started reyataz/truvada/norvir
Aug 10 - cd4 380 vl 4k (12 days after starting meds :))
Sep 10 - cd4 520 vl 1.5k
Oct 10 - cd4 590 vl 44
Jan 11 -cd4 610 vl <40 cd4% 50
May 11 - cd4 780 vl UD

Offline Rev. Moon

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Re: Went off in a huff...
« Reply #14 on: July 25, 2010, 05:30:03 pm »
Welcome back Ms. Leese. 

Good luck and health now that you are starting meds.
"I have tried hard--but life is difficult, and I am a very useless person. I can hardly be said to have an independent existence. I was just a screw or a cog in the great machine I called life, and when I dropped out of it I found I was of no use anywhere else."

Offline leese43

  • Member
  • Posts: 257
Re: Went off in a huff...
« Reply #15 on: July 25, 2010, 05:42:08 pm »
Welcome back Ms. Leese. 

Good luck and health now that you are starting meds.

Thank you Rev.  :)
Oct 04 - Neg
Aug 05 - infected
Oct 05 - cd4 780, vl 60k
Apr 08 - cd4 430, vl 243
Jul 08 - cd4 550, vl 896
Nov 08 - cd4 730, vl 1.8k
May 09 - cd4 590, vl 1.5k
Sep 09 - cd4 460 vl 34k
Dec 09 - cd4 470 vl 42k
April 10 - cd4 430 vl 88.5k
July 10 - cd4 330 vl 118k
Aug 10 - started reyataz/truvada/norvir
Aug 10 - cd4 380 vl 4k (12 days after starting meds :))
Sep 10 - cd4 520 vl 1.5k
Oct 10 - cd4 590 vl 44
Jan 11 -cd4 610 vl <40 cd4% 50
May 11 - cd4 780 vl UD

Offline hotpuppy

  • Member
  • Posts: 555
Re: Went off in a huff...
« Reply #16 on: July 25, 2010, 07:41:31 pm »
Thanks Ann.

I did wonder if she's not quite up to scratch on the meds, when I mentioned it she hadn't heard of Isentress and had to look it up in her book.

Can't fault her on anything else though, I've had every test under the sun to make sure I dont have any underlying problems due to the sickness. She's a locum and I get my regular doc back in September, if I come away unhappy with what she prescribes I may hold out a month and see what my doc says.

Leese

Hi Leese,
  I recommend the gym over the toilet for weight loss..  But hopefully you will be able to enjoy your new physique by the pool.   8)

Reyataz/Norvir/Truvada are a good combo.....

Reyataz has a tendency to cause some jaundice like conditions by elevating bilirubin... so you have to watch your liver numbers and if you are sensitive to your appearance this is something to consider.  I was on Reyataz/Norvir for a while and had slightly yellow eyes from time to time and nobody ever said anything or asked.

I figured if they had I'd yank their damn chain hard and tell them I had a fatal liver condition..... and when they said "really" I'd tell them no, of course not.... it was just a side effect of a med for AIDS! and HIV!  And on the bright side I was doing really well, undetectable, very healthy, and quite rather horny... how were they doing?  While saying this the objective is to move very close to the nosy person to make them extraordinarily uncomfortable.... put your hand on their shoulder and lean into them.  It's a deliberate invasion of their personal space and if done right should nearly guarantee that they never ask about your life again.  :)
Don't obsess over the wrong things.  Life isn't about your numbers, it isn't about this forum, it isn't about someone's opinion.  It's about getting out there and enjoying it.   I am a person with HIV - not the other way around.

Offline leese43

  • Member
  • Posts: 257
Re: Went off in a huff...
« Reply #17 on: July 28, 2010, 11:29:57 am »
Truvada/Reyataz/Norvir it is and I'll be starting on Saturday. I'll certainly keep youre advise in mind puppy if I start to turn yellow! lol
Oct 04 - Neg
Aug 05 - infected
Oct 05 - cd4 780, vl 60k
Apr 08 - cd4 430, vl 243
Jul 08 - cd4 550, vl 896
Nov 08 - cd4 730, vl 1.8k
May 09 - cd4 590, vl 1.5k
Sep 09 - cd4 460 vl 34k
Dec 09 - cd4 470 vl 42k
April 10 - cd4 430 vl 88.5k
July 10 - cd4 330 vl 118k
Aug 10 - started reyataz/truvada/norvir
Aug 10 - cd4 380 vl 4k (12 days after starting meds :))
Sep 10 - cd4 520 vl 1.5k
Oct 10 - cd4 590 vl 44
Jan 11 -cd4 610 vl <40 cd4% 50
May 11 - cd4 780 vl UD

 


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