Truvada/Kaletra/AZT Combo

[sf1971]

First, thank you to all who’ve shared their experiences and advice on these forums.  I’ve been fervently reading them for the past 6 months.  And I thought it was time I finally added my voice.  Most of the posting fall within the normal range of HIV disease, but what if you’re an outlier?  There ain’t much out there!

I was infected in Sept 05, confirmed by PCR in Oct 05.  Finally in Jan 06 I sero-converted.  My labs have been crazy from day 1.  They are listed below.  What has been most distressing is, of course, nothing is happening the way it “should”.  I am not following known patterns of acute HIV infection.

DATE - CD4 - Viral Load

10/25/05 - ??  - 500,000+
11/08/05 – 187 –  500,000+
11/16/05 – 231 –  168, 737
01/27/06 – 360 –  202,669
03/28/06 – 243 –  171,341
05/22/06 – 72 –  310,445 
05/31/06 – 81 –  230,702
06/26/06 – 82 - 250,001

Because of the aggressiveness of the virus, and my body’s unwillingness to put up a fight, my docs decided to start me on HIV meds.  Four of them to be exact.  Their thinking is to hit the virus very hard, and force suppression as fast as possible. A month ago, I met with HIV clinical pharmacist who offered me the three standard options, Truvada plus Sustiva OR Viramune or Reyataz.  Again, because of the aggressiveness they changed my “options” to a recommendation of:

Truvada/AZT/Kaletra.

If all goes well, they’ll “peel” away the AZT after several months of undetectable.

It blows my mind that this is all happening just months into the infection. But it is what it is. I feel/look well, but the numbers are scary.

I will start HIV meds this weekend; and pray for the best.

Anyone else out there with a similar experience? Or a similar drug combo?


  With much thanks to the many who share,
     Chris

[Tsadeeq]

You must have your doctors send a sample of your blood/virous off for both genotypic and phenotypic resistance testing.  There seems to me to be little point in throwing any drugs at the virus until you know what it is sensitive to.  So many people have multi-drug resistant strains nowadays that the chances are you are infected with one of those and you need to therefore take drugs that are going to work, which can be demonstrated by an available, if slightly costly, laboratory test.  The cost of the lab test is probably offset by the savings of 1-2 months tretment with ineffective drugs.

Your pattern may not appear typical, but do not fear, it can be brought under control and if you are compliant with your meds and take whatever you need for the side-effects (don't be afraid to ask!), you will probably live a good number of years in good healt... unless a bus happens to decide to run you over! 

[sf1971]

They did do a resistance test which indicated the virus being globally senstitive to all drugs.  They are also doing a viral tropism test (which I'm still trying to understand more about)... something to do with with receptors it uses.

[sdcabincrew74]

Glad they did the pheno/geno test, everyone should get that before starting treatment.  Your numbers are crazy, are you sure you were not exposed many, many years?  I am not questioning you, just wondering to go from uninfected to AIDS in 8 months is just insane!  I did not know it could happen so fast.  Anywho, it is probably best to hit hard with proven drugs even if they have rough side effects, once you get the virus suppressed, then you can move to "cleaner" newer drugs.  My doc did that with me.

[sf1971]

Yep, I'm sure.  I always got tested once a year for many many years.  And again, when I did suspect it was HIV back in Oct 05 becuase all the signs and symptoms of acute infection, my doc did both a PCR and an HIV-antibody test.  The PCR came back "with virus", but the antibody came back negative.  I didn't finally sero-convert until January of 06.

   And, the "proven" drug regimen is exactly my docs reasoning as well.  I hope to move to the newer drugs sooner than later.  How long did you wait before the swtich?  The HIV pharmacist suggested at least three months of undetectable before even considering a switch. 

[Tsadeeq]

I would (in essence) agree with your pharmacist about the viral load and wait period, but necessarily consider any switching unless you find the side-effects of the drugs intolerable.  Any switching MAY be more likely to lead to resistance even if resistance isn't apparent at the time of the switch.  My virus is resistant to some drugs, but not to the AZT which I have now been taking almost contnuously for about 15 years.  I like the idea of being off the AZT, but at least the side effects of that particular drug are relatively benign... the thought of pancreatitis or some other side-effects of other drugs scares me far more than the thought of being fatigued to the point where I have to spend a little more time on the sofa watching TV with my dogs around me!

Anyone else find their pets incredibly therapeutic?

  - David

[newt]

I am not sure there's any real evidence to justify extra drugs for "aggressive" strains.  But, belt and braces eh? In which case I'd want to start on Trizivir plus eg Kaletra cos Trizivir contains abacavir which is strong drug, bit stronger than the tenofovir in Truvada.  If you's gonna bomb the virus, carpet bomb the damn bastard.

Personally I'd want a CD4 over 200 + at least 6 months undetectable viral load result before dropping the AZT.

Good luck.

- matt