Author Topic: Test for Truvada levels? (Tested poz) (Read 14669 times)

testedpoz12156 · « **on:** August 06, 2015, 11:15:53 am »

Hey guys -

So I tested poz twice in rapid blood tests at a clinic and am waiting for confirmation, but I've been taking prep every day for several months. I'm interested in verifying my Truvada levels for the sake of being useful down the road in case my case is unusual (I know people will say "oh you weren't adherent.") I asked my doc about a Truvada levels test and he said they can't do that through his office / the regular lab. Do you know where I might go to get that done?

testedpoz12156 · « **Reply #1 on:** August 06, 2015, 01:29:31 pm »

This may be in the wrong forum (I can't figure out quite where to post) so feel free to lock or move to the appropriate place.

I tested poz twice in rapid blood tests at a clinic and am waiting for confirmation, but I've been taking prep every day for several months. I'm interested in verifying my Truvada levels for the sake of being useful down the road in case my case is unusual (I know people will say "oh, you weren't adherent.") I asked my doc about a Truvada levels test and he said they can't do that through his office / the regular lab. Does anyone know where I might go to get that done? Has anyone had it done here?

AusShep · « **Reply #2 on:** August 06, 2015, 08:47:24 pm »

I'm not sure what you hope to gain, you'll be testing your levels now, not when you were (likely) infected. Also, has your Dr instructed you to stop taking the Truvada right now due to resistance likelihood and for genome testing?

I'm curios though, is this your first checkup/monitoring since starting PrEP? Was a viral load test done immediately before starting medication? Any risky sex from two before starting to two weeks after starting?

tednlou2 · « **Reply #3 on:** August 08, 2015, 12:25:36 am »

I have never heard of a test, which measures the amount of Truvada or any HIV med in your body. I suppose since there are tests for controlled substances, it may be possible. However, those are existing tests, looking for illegal substances and pain clinics use it to make sure you're taking your prescribed pain med.

If there is such a test, I would imagine it could only measure the amount in your bloodstream for that day. It would not indicate whether you've been adherent for weeks or months. It wouldn't be able to say someone had taken their PrEP, when someone was infected. As with the tests pain clinics use to see if you have the pain med in your system, it can't tell whether you took the med weeks ago.

bocker3 · « **Reply #4 on:** August 08, 2015, 10:20:12 am »

It is possible that you could have a Therapeutic Drug Monitoring test done -- not sure if they have it for the components of Truvada (which is 2 drugs), but I bet if you contact a national lab, like LabCorp or Quest and ask they might be able to help find a location. What this could do is tell if you are absorbing the meds as expected by checking to see if you reach the therapeutically effective amount in your blood.
Of course, it will be costly and your insurance is not likely to cover it.

Jeff G · « **Reply #5 on:** August 08, 2015, 11:02:36 am »

There are test to measure drug concentrations but the real issue here is you do not need that testing at this time. If you do test positive and have a high enough viral load your doctor may choose to do some testing for resistance issues with truvada but it would be rare for you to have resistance issues for a drug you are adherent to, in short, there is no value in the test you are wanting to have done ... measuring the amount of truvada in your blood has nothing to do with resistance issues and will not tell you anything valuable about future treatment .

Welcome to the forums ... please only post in this thread until you have been confirmed HIV positive .

J.R.E. · « **Reply #6 on:** August 08, 2015, 04:07:51 pm »

Quote from: tednlou2 on August 08, 2015, 12:25:36 am

I have never heard of a test, which measures the amount of Truvada or any HIV med in your body.

Hey Ted, and to the originator of the thread,...

If you type TDM ( therapeutic drug monitoring ) into the search of this site, you will get some responses.

Ray

testedpoz12156 · « **Reply #7 on:** August 14, 2015, 03:09:08 pm »

Hey there!

So, good news: the positives on the rapid reaction tests turned out to be false after the 4th gen blood tests were ordered. (Amazingly, two false positives on two different tests -- and yes, I did several more tests to be sure, and a viral load count).

I learned a lot in this process from some HIV researchers, and they could find but 1 person who seroconverted while on Prep and taking Prep/Truvada consistently. This person was resistant to Tenofovir and Emtricitabine, the drugs in Truvada.

As re: the testing of Truvada levels, I meant to do it because I foresaw a situation where folks wouldn't believe I was taking the drug consistently. I realize that it wouldn't reflect if I was taking it the moment I contracted the virus, but it's usually the method by which adherence is counted in Prep efficacy studies. In the recent OLE Prep study http://www.aidsmeds.com/articles/iPrEx_OLE_results_1667_25922.shtml, the two individuals who contracted HIV on Prep were found to have no Truvada in their blood at the time of diagnosis.

As re: the other questions, it was the first checkup (pre-3 months), and a viral load test was done immediately prior, and I hadn't risky sex for 6 months (or sex at all) before starting Prep.

testedpoz12156 · « **Reply #8 on:** August 14, 2015, 03:15:19 pm »

Hey!

So the news is the positives on the rapid reaction tests turned out to be false after the 4th gen blood tests were ordered (and as such, I understand if you want to lock and move this thread, though I wonder if the information might still be valuable). (Two false positives emerged on two different tests -- and yes, I did several more tests to be sure, and a viral load count).

I learned a lot in this process from some HIV researchers, and they could find but 1 person who seroconverted while on Prep and taking Prep/Truvada consistently. This person was resistant to Tenofovir and Emtricitabine, the drugs in Truvada.

As re: the testing of Truvada levels, I meant to do it because I foresaw a situation where folks wouldn't believe I was taking the drug consistently. I realize that it wouldn't reflect if I was taking it the moment I contracted the virus, but it's usually the method by which adherence is counted in Prep efficacy studies. In the recent OLE Prep study http://www.aidsmeds.com/articles/iPrEx_OLE_results_1667_25922.shtml, the two individuals who contracted HIV on Prep were found to have no Truvada in their blood at the time of diagnosis. So it wasn't a test with treatment importance, right.

Anyway, I wanted to post this because I didn't want to discount Prep's efficacy, while at the same time acknowledging there are, while extremely rare, resistant HIV strains to Prep.

Thanks for responding. And sorry that this probably ended up in the wrong forum. Having bought friends rapid HIV tests and been the one to tell them they're positive, and going through the follow-up blood tests with the same result, I assumed that getting two rapid reactives were a fair marker for assuming a real positive, and thus got ahead of myself.

DodgerDawg · « **Reply #9 on:** August 14, 2015, 03:31:54 pm »

Yikes!

You tested positive on Prep, while engaging in sex using a condom as prescribed.

Perhaps the take away is to "double bag" and be adherent to the Prep meds, although no one has ever made the claim that Prep is 100% effective.

Take care,

DD

DodgerDawg · « **Reply #10 on:** August 14, 2015, 03:49:50 pm »

Quote from: testedpoz12156 on August 14, 2015, 03:09:08 pm

Hey there!

So, good news: I decided to repost this all over the forum...

I learned a lot in this process...

As re: the testing of Truvada levels, I meant to do it because I foresaw a situation where folks wouldn't believe I was taking the drug consistently. I realize that it wouldn't reflect if I was taking it the moment I contracted the virus... blah blah blah

As re: the other questions, it was the first checkup (pre-3 months), and a viral load test was done immediately prior, and I hadn't risky sex for 6 months (or sex at all) before starting Prep.

Hi,

Thank goodness you were using a condom as prescribed while on Prep. (Prep is not a stand alone prescription, it's Truvada and a new condom for each sex act). No one ever said that Prep is 100% effective, especially if one doesn't follow directions (such as failure to be adherent to Truvada, failure to use a condom).

Take care,

DD

testedpoz12156 · « **Reply #11 on:** August 14, 2015, 04:59:46 pm »

No, tbh, I wasn't using condoms every time. I just didn't want to provide misinformation, because from the people I connected with researching prep (and the individual who was resistant), the chance of getting HIV on prep is like winning the lottery on a plane that gets struck by lightning and falls out of the sky. We shouldn't argue that it's 100% effective, but I don't want to dissuade people from taking it.

But there's so much misinformation. $:-\$ I had a friend tell me that if you take prep and stop taking it you're at higher risk for HIV, and "well, why don't you just wait until you get HIV to take HIV drugs." It's just been staggering.

testedpoz12156 · « **Reply #12 on:** August 14, 2015, 05:04:48 pm »

Hey DodgerDawg -

I clarified this in the other forum: I didn't use a condom every time, and yes, prep isn't 100% effective. I just don't want to create misinformation, so I did the follow up post (and feel a little bad I didn't wait until getting my final 4th gen test result before posting.)

What I would say is that I believe prep is more effective than the studies suggest, at least in my experience with doctors and HIV researchers -- it's extremely, extremely hard to get HIV unless there's a failure of Prep adherence, or the virus is resistant to the drugs in Truvada. (And that the guy who got HIV while on Prep because of that resistance told me he still believes that Prep is more effective than condoms statistically at preventing HIV.)

I agree, though, that if you want the best results, condoms plus Prep can't be beat.

DodgerDawg · « **Reply #13 on:** August 14, 2015, 05:22:06 pm »

Cool!

I'm all about the voluminous information you've presented.

So the take away is; your failure to follow instructions; ie "use of a condom", resulted in you becoming HIV+.

Thanks,

DD

DodgerDawg · « **Reply #14 on:** August 14, 2015, 05:26:24 pm »

Personally I don't get the multiple postings all over the forum, over the exact same thing...

Always;

There's always a condom and Prep...

Just sayin

DD

testedpoz12156 · « **Reply #15 on:** August 14, 2015, 05:29:59 pm »

No -- the positive rapid test I did (twice) were false positives. The 4th gen blood tests came back negative.

My takeaway (hopefully) is that Prep remains highly effective, but the process of my thinking of my being positive made me do more research and outreach to folks in the HIV research community, who directed me to a single individual outside the United States who was resistant to the drugs in Truvada. My personal research and the conversations I had suggested to me that Prep is actually more effective than the studies suggest (if adhered to) -- everyone I spoke with said they'd seen no seroconversion among their patients using Prep. Except for this one individual. (Which would put the efficacy far beyond 99%).

=J

testedpoz12156 · « **Reply #16 on:** August 14, 2015, 05:32:28 pm »

Sorry! I posted in another forum because I wasn't getting replies in the first.

Again, I'm totally cool if the mod wants to lock it -- don't mean to create inappropriate threads. My goal was from a research perspective is that if I'd gotten HIV on prep, it would be valuable to understand why.

Thanks DodgerDawg for engaging me

. Prep plus a condom is the best bet.

DodgerDawg · « **Reply #17 on:** August 14, 2015, 05:39:49 pm »

Thank goodness we have you for research and outreach. What would we do without you?

DD

Jeff G · « **Reply #18 on:** August 14, 2015, 07:06:54 pm »

Since you are not HIV positive please only post in the PrEP forum from now on … All other threads will deleted if you post any where else .

You can post here in this forum … http://forums.poz.com/index.php?board=28.0

Jeff G · « **Reply #19 on:** August 14, 2015, 07:08:47 pm »

Quote from: testedpoz12156 on August 14, 2015, 05:29:59 pm

No -- the positive rapid test I did (twice) were false positives. The 4th gen blood tests came back negative.

My takeaway (hopefully) is that Prep remains highly effective, but the process of my thinking of my being positive made me do more research and outreach to folks in the HIV research community, who directed me to a single individual outside the United States who was resistant to the drugs in Truvada. My personal research and the conversations I had suggested to me that Prep is actually more effective than the studies suggest (if adhered to) -- everyone I spoke with said they'd seen no seroconversion among their patients using Prep. Except for this one individual. (Which would put the efficacy far beyond 99%).

=J

Since you are not HIV positive please only post in the PrEP forum from now on … All other threads will deleted if you post any where else .

You can post here in this forum … http://forums.poz.com/index.php?board=28.0

AusShep · « **Reply #20 on:** August 16, 2015, 12:53:12 pm »

Quote from: testedpoz12156 on August 14, 2015, 03:09:08 pm

Hey there!

So, good news: the positives on the rapid reaction tests turned out to be false after the 4th gen blood tests were ordered. (Amazingly, two false positives on two different tests -- and yes, I did several more tests to be sure, and a viral load count).

I learned a lot in this process from some HIV researchers, and they could find but 1 person who seroconverted while on Prep and taking Prep/Truvada consistently. This person was resistant to Tenofovir and Emtricitabine, the drugs in Truvada.
...

That's great news, thanks for the update.

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Author Topic: Test for Truvada levels? (Tested poz) (Read 14669 times)