2ND SET OF LABS ON ATRIPLA IM SCARED!!

[luckyone]

well had my 2nd set of labs after 56 days on atripla,i started at a VL of 65700 and a cd4 count of 471 and 32% after 30 days on meds my VL WAS 412 and cd4 count was 512 and 35%, now at 56 days on meds VL WENT up to 592 and cd4 count was 516 and 35%, while my cd4 count and % look really good im scared that my VL has increased,its only a small increase but none the less it should be going down,is it possible that i can still reach undetectable or is this a sign that i may have to possibly switch meds. PS the same type of  test was used on both set of labs.

[PozBrian]

Hi, I'd say take a breath and relax. I took nearly 6 months for me to reach UD and my CD4 count just broke the 400 level. My CD4 count did drop due to a couple minor illnesses. I got a big drop in my VL initially just like you and it bounced around there a bit until I reached UD. Don't get too hung up on just once set of numbers. Your CD4 numbers are good, wait until your next labs and then discuss it with your doctor.

[aztecan]

Hey Luckyone,

I agree, take a deep breath and relax a bit.

You had a pretty substantial load of bugs to kill off. It may take the meds a bit longer to kill them off to undetectable levels than you may have imagined.

Your CD4s are still decent, in fact, they are at the lower end of normal.

If I remember correctly, it took three months before mine dropped to below 400, which at the time was considered undetectable.

Hang in there and try not to stress about the numbers too much. I know that is easier said than done at times.

HUGS,

Mark

[luckyone]

thanks for your responses, my biggest concern was the fact that my VL has gone up 180 from 412 to 592 thats what was scaring me, but i guess the next set of labs will let me know where i stand. thank you luckyone

[esper]

Hi Luckyone, hey, I agree with Mark and PozBrian, take a breath and try to relax, your numbers are really very good.....and huge improvement from before starting. My doc has consistently told me its 6 months, more or less, for the regimen to stablize, so things can move around a bit....but to me, the move in the VL this time is tiny (again, comparing to the starting point), and the cd4 and % are fine. Give it a couple more months and that hopefully will get to the desired undetectible. I'm guessing your doc said things were fine?? Anyway, I know its natural to worry, but I think you're doing great, I hope you don't worry about it....its definitely working!!!! I'm doing ok, my next tests are end April so I'm just staying adherent and getting on with things. take care.....esper.

[newt]

What other people said about relaxing -- and see my PM

 -matt

[GNYC09]

I agree with everything that has been said above and luckyone, I've replied to your PM...

[J.R.E.]

Hi Lucky,

Just wondering,...Did you have the baseline resistance test, that the doctor asked about?


Take care---Ray

[luckyone]

yes i had a genotype test done after my poz diagnoses,the test came back sensitive(he said that meant i had no resitance to any meds)but from my understanding sometimes mutations are not detected until after treatment begins and then they"come out" so to speak.I have another test set up on 3/8/10 and will find out shortly after then whats up, right now im going to try to take everybodys advice and relax.

[winery]

Hello All

I am new here and I would really appreciate if someone could help.
Starting next week treatment and have been given the two options below:

1)
Truvada
Norvir
(2) 400mg Darunavir

2)
Truvada
Norvir
Atazanavir

Please could someone let me know if you are in the same combo? I have been hearing about Issentres and truvada together , any preference for that rather than the 2 options suggested by my doctor?


Many thanks to all.

[newt]

These are both good. The difference might be how you personally take to the combinations.

I would myself opt for atazanavir to start because (1) the pharmokinetics (how the drug is processed by your body) are more favourable - in particular tend to give a wider window on timing/adherence, and (2) darunavir has resistance busting properties which might be useful  to hang on to. The side effects are pretty much known for each combo. However, both are good choices.

Isentress, well, yes the studies look good, but it's 2 x day, which is not so handy. You need to be spot on with timing too because the barrier for resistance is low with this drug.

I could say more, ie, about ritonavir vs no ritonavir and merits/demerits of Truvada, but its getting complicated...

- matt

[luckyone]

ok  ive got my 3rd set of labs my VL has gone down to 472 wich is lower than set number 2 592 but both sets are still higher than set number one 412, cd4 #s and % are good, should i be concerned about the Viral Load not steadily dropping ,but going up and down,im only 3 months into meds (atripla, genotype non resistant,sensitve to all meds) however ive seen most numbers steadily declining, not going up and down. PS VL origanally was 65,700. thanks

[gregftl]

Just relax. Viral loads and t-cell counts change in your body every minute. It might just be that at the time u took ur blood that was ur viral load. I've been poz for 10yrs now. Been on the same meds for that entire time (combivir and viramune) and I go in every 3 months for my blood work. I can go a full year undetectable but then every once in a while I'll get a small spike in my viral load. I think it's just normal. And remember 5-6 yrs ago before the viral load test standard changed anything below 500 was considered undetectable. They changed the test to make it under 50 is undetectable. So by all of your number basically if you would have been doing blood work years ago u would be considered undetectable. I dont like that under 50 test I think sometimes that's  just impossible esp considering how everything in your body fluctuates.

[mimi1965]

 :DRelax!!!!  You are just fine!!!!  Your cd4 and your vl can be different at different times of the day.  Also if youare stressing a lot it will effect your numbers......take a deep breath and enjoy yourself!!!  It may take up to six months or more before you see a difference in your numbers.  I have been on Atripla since November of 2007 and my cd4 is 984 and I am undetectable.  As long as you are taking your meds everyday without fail you will be fine.  Get plenty of excercise and drink plenty of water you will be okay.  This is only your second set of labs...don't stress yourself about your numbers just yet.  If you are feeling better and you are getting stronger the meds are working.  I know people respond to medication differently.  Just be easy...you will be just fine...I'll be checking in with you and I know you will tell me the next time you get your labs back that they will be different and you may be undetectable!!!  Tal;k to you soon!!!  Love is in the light!!!  Always, Mimi

[luckyone]

ok have been busy working and have not checked in for a while,i got another set of labs again 2 weeks ago and im finally undetectable ,just wanted to update my thread in case anyone else has any concerns of a situation similar to mine with vl numbers going up and down in early treatment despite being adherant to meds. so far so good thanks for all the support.

[Billy B]

Hello All

I am new here and I would really appreciate if someone could help.
Starting next week treatment and have been given the two options below:

1)
Truvada
Norvir
(2) 400mg Darunavir

2)
Truvada
Norvir
Atazanavir

Please could someone let me know if you are in the same combo? I have been hearing about Isentress and truvada together , any preference for that rather than the 2 options suggested by my doctor?


Many thanks to all.

I have been taking Isentress and Truvada about six weeks now and 2X a day for the Isentress is no problem for me. My IDS told me that I had and hour before and an hour after the scheduled time to take the Isentress, but as yet I have been right on time. I have not yet had a new set of labs to see exactly what is going on blood wise, but I have already gone from slight fatigue to running five miles a day. This really helps with the "mighty wind" that I sometimes get form the Truvada.

Billy

[Inchlingblue]

Isentress, well, yes the studies look good, but it's 2 x day, which is not so handy. You need to be spot on with timing too because the barrier for resistance is low with this drug.

 

Isentress does have a low barrier to resistance but that means doses should not be missed. The timing can be off, especially if one is already undetectable.

The timing of taking raltegravir isn't that critical- so I wouldn't worry about punching the clock, but rather to aim for about 12 hours, or just twice daily.

and

That said, there is a fair bit of leeway in dosing of current medications. I generally say that if your within 2-4 hours of your target time of dosing, you needn't worry at all.



LINKS:

http://www.thebody.com/Forums/AIDS/Meds/Archive/SideEffects/Q201549.html

http://www.thebody.com/Forums/AIDS/Meds/Archive/Adherence/Q205759.html

http://forums.poz.com/index.php?topic=30541.msg381942#msg381942

http://forums.poz.com/index.php?topic=30541.msg381956#msg381956

[BrotherDavid]

well had my 2nd set of labs after 56 days on atripla,i started at a VL of 65700 and a cd4 count of 471 and 32% after 30 days on meds my VL WAS 412 and cd4 count was 512 and 35%, now at 56 days on meds VL WENT up to 592 and cd4 count was 516 and 35%, while my cd4 count and % look really good im scared that my VL has increased,its only a small increase but none the less it should be going down,is it possible that i can still reach undetectable or is this a sign that i may have to possibly switch meds. PS the same type of  test was used on both set of labs.

Hi,

Based on my experience with this med and what my doctor has explained to me, you're labs look good and although you had an insignificant elevation in you're VL, I bet you will see it decrease soon. Give it a few months and when you get more labs done, let us know. You have a good number of CD4s so you have time to give the Atripla a chance, and if needed change to a new combo.