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Author Topic: switching to new medication  (Read 14488 times)

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Offline sanitex

  • Member
  • Posts: 489
switching to new medication
« on: May 23, 2016, 01:31:32 am »


H! guys, I'd like know which of these medication is better tolerance (Nivirapine or Edurant)? I'm changing due to anxiety disorder ,panic  etc.
I'm now waitting for the result of Nivirapine to come out according to my doc.and I don't want any medication with food .
Logged
27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline Expat1

  • Member
  • Posts: 385
Re: switching to new medication
« Reply #1 on: May 26, 2016, 10:03:59 am »
You must take Edurant with a meal.  It needs the stomach acid to activate the medicine.

Nevirapine has no food requirement. There is a lead in dosing for two weeks. Then full dosing after that.  They will be watching you to see if you develop a rash in the first 2weeks.

My boyfriend was on it, and he developed the rash after a few months.  Which is unusual.  Usually it happens sooner.  He had to stop and go back on efavirenz.
Logged

Offline sanitex

  • Member
  • Posts: 489
Re: switching to new medication
« Reply #2 on: May 26, 2016, 11:52:54 pm »

  Thanks Expat1,i appreciate your concern but, i hope Nevirapine has nothing to do with CNS ( central nervous system)? I'm really seeing my ass with this Teevir. am afraid of resistance  to be frank.
« Last Edit: May 26, 2016, 11:54:59 pm by sanitex »
Logged
27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline bmancanfly

  • Member
  • Posts: 786
  • Medicare For All !
Re: switching to new medication
« Reply #3 on: May 27, 2016, 06:17:11 pm »
I switched from Atripla to Nevirapine + Truvada many years ago for the same reason - CNS side effects.  The switch helped a lot.

You don't need to do the lead in dose if you are switching directly from Sustiva to Nevirapine without a break in medication.

So long as you don't have a break in medication I wouldn't be too concerned about resistance either.

Best of luck.
Logged
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline sanitex

  • Member
  • Posts: 489
Re: switching to new medication
« Reply #4 on: May 27, 2016, 11:38:22 pm »



Thanks bmancanfly, I'm waiting for my ID doc to get back to me asap as we wait for test result .
Logged
27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline bmancanfly

  • Member
  • Posts: 786
  • Medicare For All !
Re: switching to new medication
« Reply #5 on: May 28, 2016, 09:56:45 am »
Not sure I understand what test you are waiting for.  Could you clarify?
Logged
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline sanitex

  • Member
  • Posts: 489
Re: switching to new medication
« Reply #6 on: May 29, 2016, 11:38:12 am »
   

  H! Bmancanfly, the test is for hypersensitive reaction {HLA *350*1) I can't remember  actually .
Please there's  something  I'd like to know  regarding  kidney  problems,does this nevirapine  has the same  kidney  issues  like tenofovir?
Logged
27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline sanitex

  • Member
  • Posts: 489
Re: switching to new medication
« Reply #7 on: June 05, 2016, 06:07:49 am »

  The Nevirapine  test was negative  (HLA -B* 07:03 /67:01
Negative HLA -B*35:05 .
The issue  now was  there's no three in one tablets on nevirapine  in Thailand at the  moment like (viramune xR).
My doctor was thinking  to give me three separate drugs  on which I decide better  to cheap it  here maybe  another  person might  have an idea .
He do mentioned (Recovir / nevirapine )I think generic for Truvada, that's means two separate  drugs too.
Please if anyone has any idea on this (Recovir /nevirapine ) I'd  like to  here from you asap. 
These  anxiety started much since I changed  from Atripla to Teevir and I strongly believe  that there's  something  different  from both sides, when I was taken original Atripla
It wasn't like this and my weight  was normal than now.
Logged
27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline sanitex

  • Member
  • Posts: 489
Re: switching to new medication
« Reply #8 on: June 05, 2016, 06:08:46 am »

  The Nevirapine  test was negative  (HLA -B* 07:03 /67:01
Negative HLA -B*35:05 .
The issue  now was  there's no three in one tablets on nevirapine  in Thailand at the  moment like (viramune xR).
My doctor was thinking  to give me three separate drugs  on which I decide better  to cheap it  here maybe  another  person might  have an idea .
He do mentioned (Recovir / nevirapine )I think generic for Truvada, that's means two separate  drugs too.
Please if anyone has any idea on this (Recovir /nevirapine ) I'd  like to  here from you asap. 
These  anxiety started much since I changed  from Atripla to Teevir and I strongly believe  that there's  something  different  from both sides, when I was taken original Atripla
It wasn't like this and my weight  was normal than now.
Logged
27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline sanitex

  • Member
  • Posts: 489
Re: switching to new medication
« Reply #9 on: June 07, 2016, 11:07:19 am »


Hi guys, I was about  to start my new  replacement with (Truvada or genetic  Recovir /Neviramune  but , I'm  so afraid and much concerned about the liver issue and rashes  though I've done the Nevirapine test it was negative.
Please  my question  was is it good to go on this combination?
Logged
27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline CaveyUK

  • Global Moderator
  • Member
  • Posts: 1,642
Re: switching to new medication
« Reply #10 on: June 07, 2016, 06:19:06 pm »
Moving from Atripla (or a regional variant of this) to the new combo will be a massive relief from the CNS problems you had on Atripla.

Don't worry about the rash but keep a close eye on things and contact your doctor urgently if it appears. Most people do not get the rash.

 
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Offline sanitex

  • Member
  • Posts: 489
Re: switching to new medication
« Reply #11 on: July 18, 2016, 11:21:03 am »


 Hi guys , just want to inform you that I will start my first nevirapine / Ricovir-EM  tonight. Please  any more  advice wI'll be appreciated.  But I could not get viramune xR  as one tablets instead Nevirapine two pills and Recovir-EM.
I've been waiting for stribild but it has not been available yet.so please any information could  help me  more about  the availability. I don't  know  if anyone have an information  please  cheap  in here as I would  like to wait for a night beforetaking this Nevirapine
Logged
27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline sanitex

  • Member
  • Posts: 489
Re: switching to new medication
« Reply #12 on: July 18, 2016, 11:22:32 am »


 Hi guys , just want to inform you that I will start my first nevirapine / Ricovir-EM  tonight. Please  any more  advice wI'll be appreciated.  But I could not get viramune xR  as one tablets instead Nevirapine two pills and Recovir-EM.
I've been waiting for stribild but it has not been available yet.so please any information could  help me  more about  the availability. I don't  know  if anyone have an information  please  cheap  in here as I would  like to wait for a night beforetaking this Nevirapine
Logged
27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline bmancanfly

  • Member
  • Posts: 786
  • Medicare For All !
Re: switching to new medication
« Reply #13 on: July 21, 2016, 12:06:01 pm »
Hope you are finally moving forward with this.  Usually the decision making and anticipation is the hardest part.

There are no food requirements with NVP.  There is also no advantage to what time of day you take it.  Just swallow it and follow your doctors directions. It's really quite easy if you let it be.

After you have been on the medications for a while (roughly six months)you can talk to your doctor about taking the two pills as one dose.  Many of us in the U.S., before the XR version came out, took the two pills together as one dose.

Of course any change in dosing needs to be discussed with your doctor first.

I hope you are doing well.  Try not to worry too much.  Best of luck,  and keep us posted as to how you are doing.
Logged
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline sanitex

  • Member
  • Posts: 489
Re: switching to new medication
« Reply #14 on: July 22, 2016, 12:31:52 pm »
Bmancanfly, my doc told me to take  the Nevirapine two pills and Recovir-EM at the same time, I just started it now hopefully it will be good  for me.
Anyway I'm just  panicking immediately I took the Meds now .
« Last Edit: July 22, 2016, 12:34:10 pm by sanitex »
Logged
27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline bmancanfly

  • Member
  • Posts: 786
  • Medicare For All !
Re: switching to new medication
« Reply #15 on: July 23, 2016, 11:04:20 am »
IIRC you are switching from another NNRTI (Sustiva) so your doctors dosing advice seems sound.  As I said before, many of us in the U.S. took our two pills together before the XR version came out. 

Please try and relax.  I know you are worried, but the stats are way in your favor that this will be a seamless switch.  And if it is not, there are other options. 

Try to find something enjoyable to focus your attention on and not fixate on your meds.

Best of luck and keep us posted.
Logged
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline sanitex

  • Member
  • Posts: 489
Re: switching to new medication
« Reply #16 on: August 19, 2016, 08:30:58 am »
 Hi guys,
 As I finally switched to Nevirapine/Recovir-em since 22 July,so today I want to give an update to you guys. the liver and other test is normal except my cd4 that dropped very huge.
my last cd4 was 626 and vl <40  25% but now cd4 is 396 vl <40 27%.
but since then I have been having some small issues like pains and feeling feverish in the mild night  and my monocyte is high like 12.1% .
please I be worry about the drop on cd4?
Logged
27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Online leatherman

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  • Posts: 8,617
  • Google and HIV meds are Your Friends
Re: switching to new medication
« Reply #17 on: August 19, 2016, 09:02:00 am »
Quote from: sanitex on August 19, 2016, 08:30:58 am
please I be worry about the drop on cd4?
nope. no worries.

actually the cd4 count is not a very good way to evaluate anyone's health. As long as your cd4 count is above 200, that count means little to your treatment. Guidelines now call for less cd4 testing per year (1-2 times, and with a cd4 >=500, they recommend no cd4 testing at all), and only viral load testing.

however, you seemed to have missed an important number in your own lab results, the cd4 percentage, which fluctuates much less than the absolute cd4 count and is a better indicator of health when the cd4 count is above 200

24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/6/16 cd4 396 vl <40 27%

since sept 2014, your percentage has steadily increased from 22% to 27% now putting it within the "normal" range.

Quote
This percentage is more stable than the number of CD4 cells. The average normal CD4% for HIV negative adults is about 40%. However, as with CD4 counts and other test, the range for a “normal” result in an HIV negative person is also wide – i,e. from about 25% to 65%.
http://i-base.info/qa/20

Quote
The CD4% can indicate whether this is a real change, or just a fluctuation. The CD4% is generally more stable.

The absolute CD4 count is still best at predicting risk of HIV progression.

The CD4% is the percentage of white blood cells that are CD4 cells. In an HIV negative adult the average CD4% is about 45%.(But this can range from 24% – 64%)
http://i-base.info/qa/18
Logged
leatherman (aka Michael)

We were standing all alone
You were leaning in to speak to me
Acting like a mover shaker
Dancing to Madonna then you kissed me
And I think about it all the time
- Darren Hayes, "Chained to You"

Offline sanitex

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  • Posts: 489
Re: switching to new medication
« Reply #18 on: August 19, 2016, 10:40:34 am »


 Thanks Leatherman, I really appreciate your encouragement and the explanations .
Though I really appreciate everyone efforts during  the time I was asking for help for the information about the regiment. But I still  have a long way to go to confirm  the less side effects of nevirapine.
Logged
27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline bmancanfly

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  • Medicare For All !
Re: switching to new medication
« Reply #19 on: August 19, 2016, 11:21:46 am »
I was beginning to wonder how you were doing.  I'm glad it's going well.

With an increase in CD4 percentage I wouldn't give a second thought to the drop in CD4 count.

How are you feeling?
Logged
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline sanitex

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Re: switching to new medication
« Reply #20 on: August 19, 2016, 01:59:49 pm »
 

 Hi Bowie-esq,  I can say I'm doing great despite the fluctuation on the cd4 which is very big  to my  knowledge, but Leatherman has come up with big explanation. Thank you for caring with appreciation.
Logged
27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline sanitex

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  • Posts: 489
Re: switching to new medication
« Reply #21 on: August 19, 2016, 02:00:16 pm »
 

 Hi Bowie-esq,  I can say I'm doing great despite the fluctuation on the cd4 which is very big  to my  knowledge, but Leatherman has come up with big explanation. Thank you for caring with appreciation.
Logged
27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline bmancanfly

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  • Medicare For All !
Re: switching to new medication
« Reply #22 on: August 19, 2016, 09:28:15 pm »
That's great that the med change has improved your situation.

Put the CD4 count out of your mind - it's meaningless.

Glad you are doing well.
Logged
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline sanitex

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Re: switching to new medication
« Reply #23 on: August 19, 2016, 11:23:56 pm »




  Hey my dear I'm very sorry with the wrong name I tag on you Bmancanfly..!
I appreciate your concern thanks
Logged
27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline bmancanfly

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  • Medicare For All !
Re: switching to new medication
« Reply #24 on: August 21, 2016, 10:41:18 am »
I knew what you meant.  ;)
Logged
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline eric48

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Re: switching to new medication
« Reply #25 on: August 22, 2016, 03:01:40 pm »
Doctors in Thailand have a large experience with Nevirapine, which is widely in use there.

Their pratice may include some genetic test, as you have mentionned. There are a few things like this which have been validated in Thailand , and not in other places.

So they do things based on their local experience, and results in Thailand are very good.

While speaking of Thailand that remind me something that is quite specific to Nevirapine and was presented at a conference in Bangkok.
http://www.aidsnews.org/2004/12/cohen-foto.html

You may want to check it out and see with your doctor if this is popular in Thailand, where this was first presented in 2004

Take care my friend

Eric
Logged
NVP/ABC/3TC/... UD ; CD4 > 900; CD4/CD8 ~ 1.5   stock : 6 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: Clin. Trial NCT02157311 = 4days ON, 3days OFF ; 2015: https://clinicaltrials.gov/ct2/show/NCT02157311 ; 2016: use of granted patent US9101633, 3 days ON, 4days OFF; 2017: added TDF, so NVP/TDF/ABC/3TC, once weekly

Offline Expat1

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  • Posts: 385
Re: switching to new medication
« Reply #26 on: September 20, 2016, 03:31:49 pm »
FYI
Thai Red Cross (Adams Love) now  has Stribild at $158  for a month's supply.  Cheers.
Logged

Offline sanitex

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Re: switching to new medication
« Reply #27 on: September 29, 2016, 04:01:10 am »
 

Hi guy please  urgent advice  on what to do .
I got my lab test and my ALT went to 1.050 and AST 435
But my last test Month was ALT 46 and AST 24
So what  causes the urgent rise now .I'm afraid  now
Logged
27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline sanitex

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  • Posts: 489
Re: switching to new medication
« Reply #28 on: September 29, 2016, 04:01:45 am »
 

Hi guy please  urgent advice  on what to do .
I got my lab test and my ALT went to 1.050 and AST 435
But my last test Month was ALT 46 and AST 24
So what  causes the urgent rise now .I'm afraid  now
Logged
27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline sanitex

  • Member
  • Posts: 489
Re: switching to new medication
« Reply #29 on: September 29, 2016, 11:20:29 am »
Hi ,does anyone  have this elevated liver ALT and AST  before?  Please  your  information or guidance how to  to do will help  me  a lot.
Logged
27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline eric48

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  • Posts: 1,361
Re: switching to new medication
« Reply #30 on: September 29, 2016, 11:23:07 am »
Had you escalated nevirapine as recommended ?

That is 200 mg for 15 days, then liver panel, then, if OK, carry on with 400 mg?

Hepato-toxicity , possibly due to NVP, is serious matter and Doctor visit ASAP, no delay
Logged
NVP/ABC/3TC/... UD ; CD4 > 900; CD4/CD8 ~ 1.5   stock : 6 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: Clin. Trial NCT02157311 = 4days ON, 3days OFF ; 2015: https://clinicaltrials.gov/ct2/show/NCT02157311 ; 2016: use of granted patent US9101633, 3 days ON, 4days OFF; 2017: added TDF, so NVP/TDF/ABC/3TC, once weekly

Offline sanitex

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  • Posts: 489
Re: switching to new medication
« Reply #31 on: September 29, 2016, 12:09:26 pm »


Hello , I was on atrpla for almost  10yrs but i stopped taking it on 22 july due to  anxeity issues then changed to Navirapine/ recomvir-Em . but before  changing to this regiment  my doc  sent me for  hypersensesitive test which came out nagetive .after a week i went  for ALT/AST test  it was 34 and 46  then a month   same  then    on 26  sep my ALtT 1050  AST  425 .  i just got the result  today then went to see my doc he  said i should ran some test to find out the problem.
My ID doc send me to a liver specialist doc  and he ordered many test which will come out tomorrow morning with ultrasound though I ate b4 I met him but he ordered the test and gave  essentiale forte 300mg  then ask me to come tomorrow for other test to come out .
please should i stop this  nevirapine or can this be cause of nevirapine or is it because I took alcohol like beer one bottle and to two four times a week?
Logged
27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline sanitex

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  • Posts: 489
Re: switching to new medication
« Reply #32 on: September 29, 2016, 12:13:39 pm »
Quote from: eric48 on September 29, 2016, 11:23:07 am
Had you escalated nevirapine as recommended ?

That is 200 mg for 15 days, then liver panel, then, if OK, carry on with 400 mg?

Hepato-toxicity , possibly due to NVP, is serious matter and Doctor visit ASAP, no delay

Eric48, my doc started with 400 mg and I asked him he said hence the test is negative that I should not worry and today he was asking if I took alcoholic I said yes one and half bottle sometimes four times in a week.
Logged
27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline bmancanfly

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  • Medicare For All !
Re: switching to new medication
« Reply #33 on: September 29, 2016, 01:33:48 pm »
First, and most importantly, try to remain calm. It sounds like your doctors are on top of this and investigating this appropriately.

There really isn't anything that anyone hear can recommend that would be more valuable than what your doctors are currently testing for and evaluating right now.

Do not stop your medications without your doctors knowledge.

While your liver numbers are elevated, and that is concerning, the cause could be many things - including the Nevirapine.  Leave that to the medical professionals to determine.

Sorry that you have hit this bump in the road.  Please keep us posting and let us know what the doctors determine.

@eric48.  The OP was on a Sustiva based regimen prior to switching to Nevirapine.  His doctors decided,  appropriately, that a lead in dosage wasn't necessary.  His liver numbers were normal at 30 days,  so he would have been escalated anyway even if he had done a lead in dose.  That's not the issue. 
Logged
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline sanitex

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  • Posts: 489
Re: switching to new medication
« Reply #34 on: September 29, 2016, 02:28:45 pm »
Bmancanfly thanks,  I really don't know what to do immediately I received the lab results from Red Cross clinic my brain was mad in tensed. But could  this come down  later I mean  like decrease to normal range? However what if I ask doc to switch back to Atripla or even to stop med for two days and see if the liver will come down. I couldn't sleep since  I find out today.
« Last Edit: September 29, 2016, 02:49:37 pm by sanitex »
Logged
27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline bmancanfly

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  • Posts: 786
  • Medicare For All !
Re: switching to new medication
« Reply #35 on: September 29, 2016, 05:00:59 pm »
My understanding, and correct me if I'm wrong, is that your doctors are aware of the situation and are running more tests.  Is that correct? 

It seems to me that if they felt that this was a dangerous situation that they would have recommended that you take some sort of immediate action. Right? 

I haven't gotten the impression, up to this point, that you have gotten poor medical advice from them. Would you agree?  Considering how worried you are, I'm not sure why you are not addressing your concerns directly with your doctor's office.  And I really haven't gotten a clear sense of how much communication there has been between you and your doctor's office - other than receiving your lab results.  Are you in contact with them?  Have they addressed your concerns?

If not, why not contact your doctor directly?

Please refresh my memory, if you don't mind, what country are you in?

Just stopping meds without your doctors knowledge is rarely a good idea.
Try and remain calm, this will get sorted out. It probably doesn't feel that way at the moment, but it will.

Please keep us up to date on what's going on.

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Offline eric48

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Re: switching to new medication
« Reply #36 on: September 29, 2016, 05:15:36 pm »
Quote from: bmancanfly on September 29, 2016, 01:33:48 pm
His doctors decided,  appropriately, that a lead in dosage wasn't necessary.  His liver numbers were normal at 30 days,  so he would have been escalated anyway even if he had done a lead in dose.  That's not the issue.

just happens that I do not remember why we do the lead in...

I have indeed read from patients that some doctors don't do the lead-in escalation (even at initiation)

I was discussing the toxicity issue with one of our experienced doctors, who explained me that he is doing a lead-in much more gradual than the recommended scheme (including at initiation).

I have not pursed the issue since this is way behind me.

What I can remember from these days past is that and increase in ALT/AST should be converted in the following fashion:

the lab sheet will have a 'normal' value, which you can call N (it depends slightly from lab to lab, but say around 50), then you express the ready in number of Ns. For exemple 1000 is 20N.

I have had temporary elevation up to 3N, which we explored, but, I was told at the time, are not a major concern. A real concern is when you reach 100 N (as far as my memory recollects)

At that time I did stop all OTHER medication (which included the statin) and it came back to 'normal'; I am now around 1 N (must usually below). I did not stop my ARVs.

By trial and error, found that the culprit was the statin... or, may be, the conjuction of statin and Nevirapine. And since, Nevirapine helps greatly with HIV and statin has a moderate-to-nihil effect on cardiovascual risk, there was no real choice and the statin is now gone (for ever...) 

So , as I said earlier, this is a matter that requires medical supervision.
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NVP/ABC/3TC/... UD ; CD4 > 900; CD4/CD8 ~ 1.5   stock : 6 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: Clin. Trial NCT02157311 = 4days ON, 3days OFF ; 2015: https://clinicaltrials.gov/ct2/show/NCT02157311 ; 2016: use of granted patent US9101633, 3 days ON, 4days OFF; 2017: added TDF, so NVP/TDF/ABC/3TC, once weekly

Offline sanitex

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Re: switching to new medication
« Reply #37 on: September 29, 2016, 09:49:25 pm »
Eric48, I leave in Thailand  and I do normally had my test results at Red Cross clinic  which  most us did use , then immediately I received the test results via email I was shocked I just took an excuse my work place and ran to my doc.so when he saw the the test he was surprised too and began to ask me some questions whether I took beer or any other Meds I told him normally beer as usual when I was on Atripla. Then he refers me to another liver specialist  and which I think  he told to do HCV test and others with ultrasound  which I did that yesterday evening and to come back this  morning for the results.  However  I ask him should  I stop my meds  he said  no but my concern is, if the Meds is cause of the problem  and refuse to accept my demand for stopping then it might be escalate more .though he said  I didn't have any symptoms at the moment  yes " but I'm very  afraid  because  this is test I did on Monday morning  and today  is Friday. My most concerned was  he still  believe  that  he ran the hypersensitive test which determined  whether i can take NVP  by then it was negative ."please don't  mind my English "
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27/12/07 cd4 20 vl 1m
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10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline Jim Allen

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Re: switching to new medication
« Reply #38 on: September 30, 2016, 06:48:15 am »
Hi

Sanitex really sorry to hear what your going through and I hope you find the cause and solution to the problem soon and its also great to see members engaged trying to help you  :)

Just as a soft reminder on this thread:

We are starting to lean towards gaining/giving medial advice on the thread, now this is a great place for support and information but there is no substitute for the advice and care of a doctor for anyone's medical questions and we really can't be giving medical advice here. 

Jim
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Offline sanitex

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Re: switching to new medication
« Reply #39 on: September 30, 2016, 07:04:39 am »
Just to give an up date. I visit my doctor  this morning after yesterday's  test, the results was HAV,HCV,and other viruses all negative, the ultrasound is  normal.he said I should continue with the Nevirapine because  Nevirapine  test was negative       (HLA -B* 07:03 /67:01
Negative HLA -B*35:05 .
I ask him to change he said not now lets check again nest week because today's result ALT 938 AST 313 not like Monday ALT 1050 AST 425 but said I should not drink beer but I told him I use to took beer  normal with Atripla more than now and no problem. Though I visited another specialist for liver who happen to request those test from ID doc he said  maybe beer but I should rest more.though I tried to explain to my ID doc that I thought I suppose to start this NVP  with 200mg then after 15days i should go on with 400mg he said hence the HLA-B*35:05 was negative its not from the medication.I will revisit him again next weekend.my mind is to change this meds but I'm afraid of the drug Resistance.
 .
« Last Edit: September 30, 2016, 07:13:20 am by sanitex »
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27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline eric48

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Re: switching to new medication
« Reply #40 on: September 30, 2016, 09:47:47 am »
Management in Thailand is quite different as other countries:
- they have an extensive knowledge in Nevirapine
- predictive markers of toxicity problems have been identified in Thai patients, but have not been confirmed in other countries.
(this may be an ethnicity/BMI cause)

Therefore, the rules that apply for lead-in are different in Thailand than those in place, say for the sake of exemple, in the US.

The lead-in in explicitly described the the US guidelines. Regional variations or doc-to-doc variations may occur...
The US guidelines and WHO guidelines may exhibit subtle differences

Thai doctors and institutions have consistently engaged in international clinical trials, especially with regards to existing drugs in the country.
One should not expect that the entire nation can afford 'caviar' drugs.

Therefore gaining knowledge in toxicity management of existing drugs is crucial and Thai doctors are very active into it.

You are at no risk of resistance, as long as you take your meds as precribed.

This is a good opportunity to discuss toxicity managment, in your context, with your doctor.

For exemple, in a recent official guideline, the World Health Organization has addressed the issue of Efavirenz toxicity (which is found in the Atripla, which you were taking)

Here again, Thai doctors and institutions have been very proactive in establishing the WHO guidelines.

So you are in good hand, I would presume.

Generally speaking Nevirapine has been good to me, and I hope to retain it as long as possible.

Once Bmancanfly nicely worded it this may: your mileage may vary

Keep us posted!
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NVP/ABC/3TC/... UD ; CD4 > 900; CD4/CD8 ~ 1.5   stock : 6 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: Clin. Trial NCT02157311 = 4days ON, 3days OFF ; 2015: https://clinicaltrials.gov/ct2/show/NCT02157311 ; 2016: use of granted patent US9101633, 3 days ON, 4days OFF; 2017: added TDF, so NVP/TDF/ABC/3TC, once weekly

Offline bmancanfly

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Re: switching to new medication
« Reply #41 on: September 30, 2016, 10:19:32 am »
Quote from: sanitex on September 30, 2016, 07:04:39 am
Just to give an up date. I visit my doctor  this morning after yesterday's  test, the results was HAV,HCV,and other viruses all negative, the ultrasound is  normal.he said I should continue with the Nevirapine because  Nevirapine  test was negative       (HLA -B* 07:03 /67:01
Negative HLA -B*35:05 .
I ask him to change he said not now lets check again nest week because today's result ALT 938 AST 313 not like Monday ALT 1050 AST 425 but said I should not drink beer but I told him I use to took beer  normal with Atripla more than now and no problem. Though I visited another specialist for liver who happen to request those test from ID doc he said  maybe beer but I should rest more.though I tried to explain to my ID doc that I thought I suppose to start this NVP  with 200mg then after 15days i should go on with 400mg he said hence the HLA-B*35:05 was negative its not from the medication.I will revisit him again next weekend.my mind is to change this meds but I'm afraid of the drug Resistance.
 .

Well that should come as a bit of a relief.  Your numbers are moving in the right direction.  And no Hep. which would have been my concern.

It seems that your doctors are on top of this and are monitoring the situation appropriately.

I'm not one to remain quiet if I think that any part of the medical establishment is not serving some ones best interest.  Myself, and others here, will speak up if we sense something is not right about the care that some one is getting.  I have not seen any reason for you to doubt the quality of the care you are receiving.  All the steps that your doctors have taken seem, from afar, to be appropriate and prudent.

I know that you are understandably anxious about this situation.  It's a scary thing.  But I think you need to resist the temptation to do anything without your doctors consent here.  You're in a justifiably disturbed emotional state and probably are not in the best frame of mind to make decisions - esp. decisions that run counter to your doctors advice.

The doctors plan on running add'l tests in a week,  and hopefully those will show even more improvement.  As hard as it is, be patient.  Sometimes the best thing to do is nothing.

Also, take your doctors advice and avoid alcohol for a while.

BTW.  Please put the "lead in dose" issue to rest.  That is not what the issue is here.  It's just a distraction that is unnecessarily causing you more worry for no reason.
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"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

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Offline sanitex

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Re: switching to new medication
« Reply #42 on: September 30, 2016, 12:41:41 pm »

With appreciation and big thanks to bmancanfly and Eric48, Jim Dublin  you guys have done a great thing to me by showing support by verbal and writing .
What surprised me and I don't  get it was the advice from  the gastroenterologist ,I told him that I planned to travel by next weekend and he said  I should stay home and rest hence I will  be lifting luggage and that will be a challenge to the liver too,with this it's  scaring. ..!
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27/12/07 cd4 20 vl 1m
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1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline eric48

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Re: switching to new medication
« Reply #43 on: October 01, 2016, 04:38:48 am »
When I initiated my meds, my doc told me to avoid business trip overseas, for a period of 3 months;

I assume that what is important is to keep a quick and speedy access to specialized doctors, just in case.
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NVP/ABC/3TC/... UD ; CD4 > 900; CD4/CD8 ~ 1.5   stock : 6 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: Clin. Trial NCT02157311 = 4days ON, 3days OFF ; 2015: https://clinicaltrials.gov/ct2/show/NCT02157311 ; 2016: use of granted patent US9101633, 3 days ON, 4days OFF; 2017: added TDF, so NVP/TDF/ABC/3TC, once weekly

Offline sanitex

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Re: switching to new medication
« Reply #44 on: October 01, 2016, 05:25:43 am »
Quote from: eric48 on October 01, 2016, 04:38:48 am
When I initiated my meds, my doc told me to avoid business trip overseas, for a period of 3 months;

I assume that what is important is to keep a quick and speedy access to specialized doctors, just in case.
Eric48 do you mean I can check  for another ID doc specialist  as my doc is reluctant and inability to withdraw me from  Npv  as this dangerous time.
Or you meant that the advice from the gastroenterologist is encouraging not to travel  now ?
Please  I need  more explanation  thanks dear
« Last Edit: October 01, 2016, 05:30:32 am by sanitex »
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27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline Expat1

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Re: switching to new medication
« Reply #45 on: October 04, 2016, 04:42:57 pm »
1. The Thai Red Cross Doctors are some of the best HIV doctors in the World.

2. They seem to have told you to stop drinking beer.  Yet you seem to refuse.

3. They seem to have been taking the right measured response to elevated numbers.

Echosound, HVC tests, etc.

So I suggest you let them do their job and follow their expert advice including stop drinking.

If they determine that one of the drugs in the combo is to blame, they will switch it out. 

We need to learn to live with HIV, otherwise is will do what it does.  This requires us to make some sacrifices.  Stopping beers seems like one of the more minor ones.
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Offline sanitex

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Re: switching to new medication
« Reply #46 on: October 05, 2016, 11:59:12 am »

 
Quote from: Expat1 on October 04, 2016, 04:42:57 pm
1. The Thai Red Cross Doctors are some of the best HIV doctors in the World.

2. They seem to have told you to stop drinking beer.  Yet you seem to refuse.

3. They seem to have been taking the right measured response to elevated numbers.

Echosound, HVC tests, etc.

So I suggest you let them do their job and follow their expert advice including stop drinking.

If they determine that one of the drugs in the combo is to blame, they will switch it out. 

We need to learn to live with HIV, otherwise is will do what it does.  This requires us to make some sacrifices.  Stopping beers seems like one of the more minor ones
Hi , my dear I only  took a bottle or one and hAlf that's all not even  as they think  just evening  hang out. I'm not a drunker for christ sake.
My mind  is telling  me maybe late food  with meds or maybe nevirapine might have an absorption problem with late food  intake.
Please if you know  better I'll  like to learn
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23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline sanitex

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Re: switching to new medication
« Reply #47 on: October 07, 2016, 05:12:02 am »


Hi,I want to thank you guys for the kind support and  update from my lab result this morning . so I think  it's decreasing
30/9/2016 ALT 938 AST 313
7/10/2016 ALT 513  AST 193
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27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline bmancanfly

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Re: switching to new medication
« Reply #48 on: October 07, 2016, 09:19:22 am »
That's great news.
 :D
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Offline sanitex

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Re: switching to new medication
« Reply #49 on: November 22, 2016, 09:46:39 am »
Hi,I want to thank you guys for the kind support and  update from my lab result this morning . so it finally decreased .but my doc said that I should check again in four months time for ultrasound  to know the faith and healthy of the liver.but I exempt myself from alcohol since then
I love you guys ,you guys are awesome

22/11/2016 ALT 41 AST 27

30/9/2016 ALT 938 AST 313
7/10/2016 ALT 513  AST 193
« Last Edit: November 22, 2016, 09:55:44 am by sanitex »
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27/12/07 cd4 20 vl 1m
10/4 /08 cd4 86 vl 63
1/7/08  cd4 186 vl un
16/10/08 cd4 196 vl un
23/1/09 cd4 248 vl un
10/9/11 cd4 418 vl <40 %22
13/12/11 cd4 410 vl un 23%
24/2/12 cd4 545 vl un 26%
22/2/12 chge trv to Recovir-em.10/9/11 cd4 418 vl <40 %22
7/7/12 cd4 359 vl <40 22%
23/8/12 cd4 400 vl <40 23%,
testosterone test 7.5 ng/ml and
thyroid (TSH)1.32 ml.
13/12/2012 cd4 523 24% vl <40
18/3/2013 cd4  513  23% vl <40
03/8/2013 cd4 429 22% vl <40
13/11/2013 cd4 455 23% vl <40
Anti-HBs testquantitative Anti-HBs pos
Titer 16.95 mlu/ml <10.00
22/3/14 cd4 396 vl <40 24%
24/7/14 tevir
24/9/14 cd4 517 vl <40 22%
16/3/15 cd4 545 vl  85 24%
12/4/16 cd4 626 vl <40 25%
16/8/16 cd4 396 vl <40 27% changNVP/recovir-em 22/7
8/12/16 cd4 511 vl ud 23%
5/6/16 cd4 688 vl ud %27
17/9 /20  chng TLD

Offline eric48

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Re: switching to new medication
« Reply #50 on: November 22, 2016, 10:17:39 am »
Good news - take care - Eric
Logged
NVP/ABC/3TC/... UD ; CD4 > 900; CD4/CD8 ~ 1.5   stock : 6 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: Clin. Trial NCT02157311 = 4days ON, 3days OFF ; 2015: https://clinicaltrials.gov/ct2/show/NCT02157311 ; 2016: use of granted patent US9101633, 3 days ON, 4days OFF; 2017: added TDF, so NVP/TDF/ABC/3TC, once weekly

Offline bmancanfly

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Re: switching to new medication
« Reply #51 on: November 24, 2016, 11:13:09 am »
That's great news.  I'm very happy for you.  :)

Many people, on the regimen that you are on, are able to maintain side effect free viral suppression for a very long time.  Best of luck.
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Offline Expat1

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Re: switching to new medication
« Reply #52 on: November 24, 2016, 05:53:09 pm »
Glad to see it is working out.
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