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Author Topic: Changing Treatment  (Read 4034 times)

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Offline anthony

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Changing Treatment
« on: January 20, 2014, 04:06:17 pm »
Hi,
I've been on tratment with Prezista, Norvir and TRuvada since May 2012. I had, at that time 22 cd 4 (6%). After 2 months and half I reached 250 cd 4 (16%) and viral load ud. My cd4 stayed around 250 for the following 10 months (224-264) ut the % reached the 21%, slow by slow. My dctor decided to add Isentress and cholostrum bovinum at the end of May 2013 and in the middle of September cd4 raised up to 378 (27%) with our big surprise. Last test (taken one week ago) however showed 350 cd4 (24%). My doctor says that it could be a normal fluctuation and I don't have to worry about. However he would like to substitute the Truvada with Epivir (3TC or lamivudine), because he says that 4 different medicines are too much  (and, he says the tenofovir in the Truvada, being very toxic, could keep the cd4 low, while the 3TC is less toxic and it could help raise the cd4). Any one on Prezista, Isentress and Epivir (Lamivudine). What's your experience? What do you think? Thank you for your answers.
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Offline buginme2

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Re: Changing Treatment
« Reply #1 on: January 20, 2014, 04:51:01 pm »
 To me it sounds like your doctor doesn't know what he is taking about and I would go to another HIV  specialist for a second opinion.

 Where do you live?

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Don't be fancy, just get dancey

Offline anthony

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Re: Changing Treatment
« Reply #2 on: January 20, 2014, 05:27:38 pm »
I live in Italy. My doc says that the huge increase of cd4 is due to the Isentress and he want to keep it along with Prezista; but instead of Truvada he proposed me Epivir (3TC) in order to have only 3 medicines instead of 4. Moreover he says, that the Truvada (especially the tenofovir included in it) sometimes may not help the cd4 raise quickly because, sometimes it can lower the WBC because of it's toxicity. To confirm that, he says that people who have been take off of Truvada (with 3 or 4 years of treatment, at least, and with more than 500 cd4) have had a big increase af Cd4 with the montherapy of Prezista + Norvir.
Anybody on Prezista (+ Norvir), Isentress abd Epivir (Lamivudine or 3tc)?
Thank you for your answers
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Offline anthony

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Re: Changing Treatment
« Reply #3 on: January 20, 2014, 05:30:13 pm »
Of course the monotherapy is ot for my case and neither the therapy with Isentrees and Prezista, because, I've been on tratment for less than 2 years; that's why he wants to add a 3rd medicine: 3tc
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Offline newt

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  • the one and original newt
Re: Changing Treatment
« Reply #4 on: January 20, 2014, 05:49:05 pm »
The combination your doc suggests is fine, Isentress is noted for 50+ increases in CD4 count, the breast milk is pure speculation though.

This:

Quote
tenofovir in the Truvada, being very toxic, could keep the cd4 low, while the 3TC is less toxic and it could help raise the cd4

is rubbish, scientifically speaking. Tenofovir might depress CD4 count modestly, but it might not, and if it does, it might not matter, and "very toxic" it is not. This said, I am not taking it for theoretical concerns about long term side effects on bone etc. There is no evidence 3TC raises CD4 count, and anyway yours is high enough to be good.

- matt

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"The object is to be a well patient, not a good patient"

Offline newt

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  • the one and original newt
Re: Changing Treatment
« Reply #5 on: January 20, 2014, 05:50:17 pm »
Plus there is no way you can do monotherapy with Isentress, it's just not strong enough. Prezista yes, perhaps (but I'd keep the 3TC, indeed, I am on Prezista plus FTC, a drug near enough the same as 3TC). - matt
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"The object is to be a well patient, not a good patient"

Offline anthony

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Re: Changing Treatment
« Reply #6 on: January 20, 2014, 05:53:32 pm »
Quote from: newt on January 20, 2014, 05:50:17 pm
Plus there is no way you can do monotherapy with Isentress, it's just not strong enough. Prezista yes, perhaps (but I'd keep the 3TC, indeed, I am on Prezista plus FTC, a drug near enough the same as 3TC). - matt
Thank you Matt,for your advises!!!
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Offline eric48

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Re: Changing Treatment
« Reply #7 on: January 20, 2014, 05:53:48 pm »
Quite unusual course, but , if it worked, can't blame the doc

Then why keep the 3TC (or FTC) ?

Prezista, Isentress (dual therapy) would be unusual.

Better : Prezista + Tivicay (with the 2 higgest barriers to resistance, why need a third molecule?) and that would be once daily...

Quite unusual course... Cheers

Eric
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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 newt

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Re: Changing Treatment
« Reply #8 on: January 20, 2014, 05:55:58 pm »
Quote
Better : Prezista + Tivicay (with the 2 higgest barriers to resistance, why need a third molecule?) and that would be once daily...

..because Tivicay is not available?

- matt
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"The object is to be a well patient, not a good patient"

Offline anthony

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Re: Changing Treatment
« Reply #9 on: January 20, 2014, 06:14:24 pm »
Quote from: newt on January 20, 2014, 05:55:58 pm
..because Tivicay is not available?

- matt

You're right, Tivicay is not available yet in Italy and my doctor would like to add a 3rd molecule (3tc) to Prezista and Isentress. By the way, I'm taking Isentress twice a day, because my doc say that its' most effective than once. Is that true?
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Offline eric48

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Re: Changing Treatment
« Reply #10 on: January 20, 2014, 06:19:27 pm »
yes.  eric
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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 anthony

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  • Posts: 6
Re: Changing Treatment
« Reply #11 on: January 20, 2014, 06:47:37 pm »
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