Started Atripla at 384-Should I stop if it goes up?

[indyguy]

Hey all a question for you. My IM doctor started me on Atripla after my first blood work when my count was 384. My next blood work results come back this week. My question is if I have a good increase in my numbers should I ask my doctor if I can stop using the medication? He has advised me to quit smoking and I start the new medication for that tomorrow. This is only my second round of blood work since being diagnosed in November of 06. Your thoughts?

[aztecan]

Hey Indyguy,

It is unusual to begin meds after only one set of labs, but not unheard of. Ususally, I have seen it in people who either have a very low CD4 or a very high viral load, recent seroconversion not withstanding.

Were your viral loads high? Do you know what  your percentage is or was when you started. All of these could have played a role in starting so quickly after diagnosis.

That said, the goal is to stay healthy. I hope your CD4s have risen and viral load dropped like a rock.

Once you start meds, it is unwise to stop. My CD4s have been more than 1,000 for years now, except for one blip when they dropped to 900-something. My viral load also has been undetectable all that time, again aside from that one blip I believe was caused by faulty handling of the blood sample.

I would talk to your doc and see what he/she says. But, if you are doing well on the meds and they aren't causing you problems, I don't really think I would consider stopping were I you.

HUGS,

Mark

[Ann]

Your IM doc? Am I correct in thinking you mean he's an Internal Medicine doc?

If that's correct, you might want to think about getting with an ID (Infectious Disease) doctor or an hiv specialist. You report in another post that your VL when first diagnosed was only 17,000. Most ID docs would NOT have started you on the meds with only one lab result and good numbers. Yes, 384/17,000 are GOOD numbers.

This, combined with his pestering you to seek mental health care over your decision to not quit smoking right now, is ringing all sorts of alarm bells from where I'm standing.

Ann

[indyguy]

Hi Ann I picked this guy because I had heard from allot of gay folks that I know that he is good and also treats allot of HIV folks. I did not know there was a difference between a ID and a IM doctor. I figured because the HIV was blood related that there would be no difference. I also welcome any advise from others out there and value you opinion greatly. This is truely something I was not aware of.

[Miss Philicia]

I thought "infectious disease" was a sub-specialty of Internal Medicine.

Is this not correct?

I know my HIV doctor has board certification in both IM and ID but frankly I don't know the intricacies of it all.

[blondbeauty]

Usually meds are never stopped if you can tolerate them. But some people choose to stop them for even years with no problems (always supervised by a Dr.). I met a guy in Barcelona who stopped his treatment for 3 years and did very well. He was doing ok with the treatment but he wanted to rest a little.
Usually when patients stop meds Drs. want them to have their blood work done more frecuently. For me that is much worse than taking pills every day. The less visits I make to the hospital the better. So you have to evaluate what interferes more with your daily life.
My Dr. is also an internal medicine specialist. There is a specialist in HIV in the same hospital but as long as my meds keep working and no complications that he can not handle emerge I won´t "use" him.