General Questions -

[voyager71]

Hello Everyone~

I have not posted on here since 12/26/06 - but I'm back...

I am a newbie on meds so bare with me please....

In December I was put on Atripla but ended up having bad side effects from the Sustiva, including a rapid/racing heart beat, my HIV Doc decided to take me off the Atripla even though my T cells were at 971 and my Viral load is Undetectable. I went 2 weeks without meds and after all of my medical tests (stress test, EKG, and blood work) I had no heart disease or damage, but just to be safe she put me on a different regimen

Invirase 500mg x3
Norvir 100mg x1
Truvada x1

This seems to be working better, than the Atripla my counts as of June were T cells at 878 and viral load is still undetectable.

My question for this is: Will the meds cause cardiac issues and if so what should I be aware of?

My PCP is concerned because my Cholesterol is at 203 but my good Cholesterol is at 173 - the percentage has changed though from 35% in June down to 31%. I refused any Cholesterol meds as I did not feel that 203 was that seriousness of a number - was I wrong? 

I was told to take 3000mg of Omega 3 a day morning noon and night that should help keep my cholesterol in check. Along with my other daily vitamins - which are a Multi 2X's a day, B-Complex, B-12, 1000mg of C - does anyone know what other vitamins may be beneficial or worth me taking a look at? I have heard that a lot of poz people drink Aloe Juice, anyone have experience with that - what are its benefits and does it work? 

I see a nutritionist once a year at the Clinic I go to and frankly I do not get anything out of the visit with her, so I take in stride things she tells me.

I think I have rambled on enough, sorry if I seem dumb about this but just trying to get help, I hope that is OK.

Thanks
Eternally Single Jeff....hehehehe
aka Tigger

[DCGUY2007]

Just speaking from my experience. I haven't had any cardiac problems with the meds. Hope everything works out

[tinydaniell]

voyager,

fish oil and flax seed oil are both good at bringing your lipids in  line just take care

michael

[newt]

A handful of people have had cardiac problems on Invirase, but this is not definitively linked to the drug (ie just they were on it and the probs were reported).

The recommended dose of this drug is 2 x 500mg Invirase tablets, + 1 x 100mg Norvir capsule, twice a day. << so am a bit mystified by the 3 caps in your original post.

Your (total?) cholesterol at 203 is on the edge of ok (200 cut-off). In case you are interested you can calculate your 10 year CV risk (risk of a heart attack) here.  With PIs, the thing to watch for long term is developing insulin resistance and increasing lipids, but Invirase is one of the better ones in this respect.

Invirase on AidsMeds

Invirase prescribing info PDF

Good luck

[BT65]

My cholesterol went way up in the last year, mainly due to the meds.  But I take Lipitor, which is a great med for lowering cholesterol almost immediately. 
   I don't know anything about drinking Aloe juice.  I used to be a fanatic about taking all kinds of vitamins and herbs, but not anymore.  I just take a multivitamin once a day.  I don't want to "overdose" on tons of vitamins. 

[redhotmuslbear]

My PCP is concerned because my Cholesterol is at 203 but my good Cholesterol is at 173 - the percentage has changed though from 35% in June down to 31%. I refused any Cholesterol meds as I did not feel that 203 was that seriousness of a number - was I wrong? 

I was told to take 3000mg of Omega 3 a day morning noon and night that should help keep my cholesterol in check. Along with my other daily vitamins - which are a Multi 2X's a day, B-Complex, B-12, 1000mg of C - does anyone know what other vitamins may be beneficial or worth me taking a look at? I have heard that a lot of poz people drink Aloe Juice, anyone have experience with that - what are its benefits and does it work? 

Tigger,

For starters, your cholesterol numbers don't compute.....  good cholesterol at 173 is WAAAAY above normal, and it's not 30-some percent of 203.   

Rather than ingesting so much omega-3 goop -- it's fat, after all, and it gets out of balance with omega-6s -- try extended-release niacin.  High doses of niacin cause intense flushing and "hot flashes," but the extended release (usually bound by beeswax or another digestable substance) will allieviate that effect.  To have much effect on cholesterol -- it's boosts the good and helps keep down the bad -- one needs to get up to 1500-3000mg a day, though, usually split morning and night.  I've been using niacin for about three years because I inherited low HDL from my father.  At the beginning, my HDL was in the low 20s, now it's in the high 30s consistently.

Another effective compound for cholesterol control is policosanol, a derivative of sugar cane.  I believe it's a 10 or 20mg capsule once daily.

If you buy supplements, shop carefully and steer clear of stores like GNC.  I use Target for my 'normal' vitamins, a big internet and mail order firm www.DoctorsTrust.com for my supplements like those mentioned here, and a couple of eBay merchants for other good stuff like glutamine powder.

Cheers,
David

P.S.  Norvir can easily mess up your cholesterol.  Any reason why you could not dump the Invirase and Norvir for Viramune as a simple non-nuke component?

[buca45]

I have an extensive  family background with both Heart Problems and Cholesterol Issues on both my mother and fathers sides.
I always am concerned when trying a new combo about how the meds will affect my heart health and cholesterol. My doc is also very good about considering these background problems.
He recommends the heart stress test yearly, (have had two angiograms in 4 years) and he also does an EKG on each 6 week visit. I am on Pravastatin and have been for years now. Even though I eat well and consider this when menu planning, my level stays around or above 200 constantly.
My only  recommendation is to research on your own each meds side effects and what, if any, chances they may cause problems down the road. Although I have 100% faith and confidence in my doctors knowledge, we enter each decision together after considering all the factors involved.
He is constanly praising me for my pro active stance on fighting this disease and remaining healthy and listens carefully to what I have contribute.
As far as vitamins, after much research and his recommendations, I am now on GNC Mega Men Ultra Mega Greens, a three pill daily dosage as well as a product called Colon Cleanse also from GNC. The added bulk helps to keep cholesterol in check. I appreciate the way GNC has many mens products to chose from and I have found a salesman who knows my status and has made it his duty to read up and find things he thinks will assist in my fight.
Good Luck and research as much as possible!!

[aztecan]

Hey Tigger,

Reyataz is one of the more lipid-friendly PIs, but I read where it has caused some people to have irregular heart beats, so that may be a concern.

The fish oil and flax seed oil are definitely a good idea. Regular exercise is good.

Your cholesterol numbers have me confused as well. But I gather your HDL is really good.

I took extended release Niacin. It did nothing for me, except give me hot flashes. Some report good results though.

Of course, I would check with your doctor about this because Niaspan (the brand name I used) can cause problems as well.

Edited to add: I would not start any over-the-counter niacin treatments without discussing it with your doctor.  Non-prescription treatments, even though it is a vitamin, can cause problems.

As far as the Viramune goes, your CD4s are too high. Men with CD4s greater than 400 who start Viramune run a much higher risk of developing serious liver problems.

I haven't taken Invirase since they reformulated it. I had issues with it, but that was back when it was unboosted and had to be taken with a full fat meal and 8 oz of grapefruit juice.

From what I've heard, from Newt and others, it works very well and is much less problematic these days.

It may be that, down the road, you could be looking at another med to counteract the lipid issues. Pravachol (Pravastatin) is usually one that works without causing problems with the PIs. Crestor is another, I believe.

I'm sure your doc would have an opinion on these.

Let us know how things work out.

HUGS,

Mark