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Author Topic: 99.99% VL drop after only 2 Weeks Treatment. But.....  (Read 7647 times)

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Offline todd123

  • Member
  • Posts: 67
  • "You don't ask, you don't know."
99.99% VL drop after only 2 Weeks Treatment. But.....
« on: August 19, 2008, 12:46:29 am »
Just wanted to post an update which is great ...I think.  My viral load dropped 99.99% according to my doc.
There was a "log 5" decrease and the numbers went from 400,000 to 1500 a 2 weeks ago when I just started treatment  Cd4 increase was 16 to 64.
Needless to say, I am relieved and partially thrilled with the ressult of the meds: prezista/norvir,, intelence,
isentress.  My doctor said he had never seen such a decrease like this before. At this point, I'm tolerating them pretty well.
My question is that since this treatment is not recommended for treatment naive patients, but for those
who have developed resistance, have I been put on these drugs prematurely? What does it mean for the future use of other
drugs should I need them?
My doctor in NYC, after consulting with 2 other HIV specialists thought it best to put me on these meds.
In fact, he said they all agreed.  This was due to such a low tcell count, and sexual history. Crystal Meth strikes again!
He thought there was a good chance that I had possibly already been exposed to resistant strains and they all
felt that, with that CD4 count and the long wait to get the resistance test back.  I'm anxiously await that result.

Am I "overthinking" this? Was my doctor wrong?  He has a great deal of experience with this and I really trust him.

I look forward to hearing from you.


Tested HIV+ July 28, 2008
CD4 16 VL over 400,000
Started Prezista/Norvir, Isentress and Intelence; Mepron
8/08   CD4 64    2%      VL 1500
9/08   CD4 135  6%      VL 371
11/08 CD4 104   9%     VL 156
12/08 CD4 161   9%     VL 400
01/09 CD4 109   7%     VL 351
02/09 CD4 218   8%     VL   98
03/09 CD4   80   5%     VL   98 at least that's the same
04/09 CD4 150   7%      VL 100
05/09 CD4 232   8%      VL   90

Offline next2u

  • Member
  • Posts: 1,813
congrats on the awesome viral load decrease. dude, if your docs came to that conclusion and the results have outstanding then hopefully it wont be a bad start. im sure the others will chime in later. im not on meds and don't have much knowledge on the matter. just wanted to scream out a big ol kudos to you for the improvement in your status.

best,
d
midapr07 - seroconversion
sept07 - tested poz
oct07 cd4 1013; vl 13,900; cd4% 41
feb08 cd4  694;  vl 16,160; cd4% 50.1
may08 cd4 546; vl 91,480; cd4% 32
aug08 cd4 576; vl 48,190; cd4% 40.7
dec08 cd4 559; vl 63,020; cd4% 29.4
feb09 cd4 464; vl 11,000; cd4% 26
may09 cd4 544; vl 29,710; cd4% 27.2
oct09 cd4 ...; vl 23,350; cd4% 31.6
mar10 cd4 408; vl 59,050; cd4% 31.4
aug10 cd4 328; vl 80,000; cd4% 19.3 STARTED ATRIPLA
oct10 cd4 423; vl 410 ;); cd4% 30.2
jun11 cd4 439; vl <20 ;); cd4% 33.8 <-Undetectable!
mar12 cd4 695; vl ud; cd4% 38.6
jan13 cd4 738; vl ud; cd4% 36.8
aug13 cd4 930; vl ud; cd4% 44.3
jan14 cd4 813; vl ud; cd4% 42.8
may14 cd4 783; vl *; cd4%43.5
sept14 cd4 990; vl ud; cd4% *
jun15 cd4 1152; vl ud; cd4% *
july15 - STRIBILD
oct15 cd4 583; vl 146; cd4% 42
mar16 cd4 860; vl 20; 44

Offline weasel

  • Member
  • Posts: 1,906
HEY TODD  :),
                       well that IS good news !
  I do NOT know why doctors PICK our " cocktails " the way they do  ::)
BUT they seem to know what they ARE  doing !
I started meds sept 10th ,2004 . FULL BLOWN AIDS !
The doctors made it sound like if i went another month I would have CROAKED !
 In two weeks they got my virous load down to almost nothing !
I was in amazment , and quite franklly still am !
  THE MEDS WORK ! , just make sure you NEVER miss a dose !
 Missing doses makes for resistance !
 I have never missed a dose , things are OK , BELLY problems but untectable for 4 years !
and feeling good .
 If I were NOT so inti-exersize I would feel even better !

                                                            best of luck , you got it made  :),
                                                                                                               Karl
" Live and let Live "

Offline wow1969

  • Member
  • Posts: 208
Re: 99.99% VL drop after only 2 Weeks Treatment. But.....
« Reply #3 on: August 19, 2008, 10:25:41 am »
You've been diagnosed less than I have but I can tell you that the worst part for me has been the waiting and not knowing ... Once I got all my first tests results in and had a place to start from I actually felt better ... Hang in there it does get better

Blessed Be

Offline Iggy

  • Member
  • Posts: 2,434
Re: 99.99% VL drop after only 2 Weeks Treatment. But.....
« Reply #4 on: August 19, 2008, 10:47:32 am »
Todd,

I assume your doctor performed a Genotype after your diagnosis?  I'm linking the information from the Lessons section below, but this would have told your doctor if you had any known resistances to certain meds.

http://www.aidsmeds.com/articles/Resistance_4745.shtml

Offline blondbeauty

  • Member
  • Posts: 1,787
Re: 99.99% VL drop after only 2 Weeks Treatment. But.....
« Reply #5 on: August 19, 2008, 11:23:32 am »
There is no reason why you should not use these meds as a first line treatment. First line does not mean that a treatment has to fail sooner or later and be replaced by a second line treatment. It can be the first and definite treatment for you.

Nobody knows if you are resistant to other meds. If you already are resistant it is not the drug's fault. On the other hand, taking these drugs is not going to make you resistant to older drugs. Latest drug is not a synonymous of last chance of getting an effective treatment for you. It that was the rule, we should all start with old treatments: azt, d4t, etc. Even these old drugs, if used with todays knowledge, should never fail, despite their undesirable side effects.

You are lucky of having started with the newest drugs. I was not tested for resistance before starting treatment. The first treatment worked. Maybe I am resitant to IP since my infection but I will never know unless I try to use IP. I have no intention of changing my current regime.
The only member in these forums approved by WINBA: World International Nail and Beauty Association.
Epstein Barr +; CMV +; Toxoplasmosis +; HIV-1 +.
Counts when starting treatment:
V.L.:80.200 copies. CD4: 25%=503
Started Sustiva-Truvada 14/August/2006
Last V.L.count (Oct 2013): Undetectable
Last CD4 count (OCT 2013): 52%= 933

Offline atlq

  • Member
  • Posts: 518
Todd,

The combo you are you been studied almost exclusively in people with past resistance issues, not treatment naive individuals. That is because Intelence overcomes resistance mutations common to the current class of NNRTI's, Prezista has a higher barrier to PI resistance than the other PI's and Isentress, as a drug in an entirely new class, has no cross resistance issues with current meds.

That is certainly not to say that your docs are wrong. Did you have any prior ARV (med) use? If so, they probably thought it best to put you on a regimen which had the best chance of overcoming any possible drug resistance. With a cd4 of 16, starting as soon as possible was probably wise..

It is a potent combo and seems to working well for you. Perhaps when you get your resistance tests back, you can discuss discuss your full range of med options with your doctor.

Bottom line: You can't argue with those results...Congratulations! ;D

 edited for typo...

« Last Edit: August 19, 2008, 12:28:24 pm by atlq »
“Keep up the good work....   And God bless you.”
  --  Sarah Palin, to members of the Alaskan Independence Party, 2008

Offline Ann

  • Administrator
  • Member
  • Posts: 28,134
  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: 99.99% VL drop after only 2 Weeks Treatment. But.....
« Reply #7 on: August 19, 2008, 03:13:17 pm »
Hi Todd,

I merged your threads so you have all your responses in one place.

Ann
Condoms are a girl's best friend

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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline todd123

  • Member
  • Posts: 67
  • "You don't ask, you don't know."
Re: 99.99% VL drop after only 2 Weeks Treatment. But.....
« Reply #8 on: August 22, 2008, 03:02:15 pm »
Got the resistance test back and found out that I'm resistant to about half of the available drugs, one of which my doc would
have normally put me on.   So it looks like he maid the right decision.  Remember this is the first time I'm on treatment.
Please be careful of those multiple strains. 

best.
Scott
Tested HIV+ July 28, 2008
CD4 16 VL over 400,000
Started Prezista/Norvir, Isentress and Intelence; Mepron
8/08   CD4 64    2%      VL 1500
9/08   CD4 135  6%      VL 371
11/08 CD4 104   9%     VL 156
12/08 CD4 161   9%     VL 400
01/09 CD4 109   7%     VL 351
02/09 CD4 218   8%     VL   98
03/09 CD4   80   5%     VL   98 at least that's the same
04/09 CD4 150   7%      VL 100
05/09 CD4 232   8%      VL   90

Offline atlq

  • Member
  • Posts: 518
Re: 99.99% VL drop after only 2 Weeks Treatment. But.....
« Reply #9 on: August 22, 2008, 03:18:13 pm »
Scott,

Yes, unfortunately more people are being infected by virus that is contains med resistant strains.

As you said then, it sounds as if your docs  did the right thing. Judging from your incredible VL drop, I bet you will be undetectable soon! keep it up... ;D
“Keep up the good work....   And God bless you.”
  --  Sarah Palin, to members of the Alaskan Independence Party, 2008

Offline risred1

  • Member
  • Posts: 419
  • My Source for Supps - www.newyorkbuyersclub.org
Re: 99.99% VL drop after only 2 Weeks Treatment. But.....
« Reply #10 on: August 26, 2008, 11:07:42 am »
Just to catch up...

Your doctors essentially determined that in the time frame of getting your resistance test back, you were at considerable risk and put you on these newer medications.

These newer drugs were tested on treatment experienced folks who were experiencing resistance issues and/or treatment failure. There are many reasons why this is done, more than I care to elaborate, but there is a movement underway to change testing procedures from those who are treatment experienced and experiencing treatment failure to a new types of testing because the pool of those available for testing is essentially shrinking, making it more difficult to get the number of candidates required to perform Phase II and III testing.

It is not that these drugs are "inappropriate" for treatment naive folks. Just that there is much more defined and refined information about the current front line drugs, that have gone well beyond Phase III testing, and now are in the comparative testing world, where one drugs is being evaluated against others to determine best efficacy, durability, and side effects.

Additionally, these recommended front line drugs have a history about them which helps docs understand what the longer term implications are as compared to these even newer drugs.

And you are not necessarily working backwards here. There may be front line drugs that are still available to you, if you ever develop resistance. Simply, these are just the newer drugs, where less is known VS what is known about current drugs.

It wasn't that long ago that Kaletra was the PI of choice or "gold" standard. And its still a potent and popular front line med. When Reyataz was introduced, my doc had a wait and see attitude, although the testing showed it seemed to be better tolerated than Kaletra. In post phase III testing, in head to head comparisons, once it was determined that Reyataz has essentially the same performance as Kaletra, it then was listed as a preferred front line med, elevated from Alternative.

The above is a gross simplification of what is the process for drugs, but I think you get the idea.

In my view, as knowledge of HIV increases and treatments become more refined, and as head to head testing establishes these newer drugs as viable alternatives to the Preferred List, we all benefit from having more choice and options to suppress the virus.
risred1 - hiv +
02/07 CD4 404 - 27% - VL 15k
10/07 CD4 484 - 31% - VL 45k
05/08 CD4 414 - 26% - VL 70k
01/09 CD4 365 - 23% - VL 65k
05/09 CD4 291 - 23% - VL 115k - Started Meds - Reyataz/Truvada
06/09 CD4 394 - ?% - VL 1200 - Boosted Reyataz with Norvir and Truvada
07/09 CD4 441 - ?% - VL 118 - Boosted Reyataz with Norvir and Truvada
09/09 CD4 375 - ?% - VL Undetectable - Boosted Reyataz with Norvir and Truvada
12/09 CD4 595 - ?% - VL Undetectable - VIT D 34 - Reyataz/Truvada/Norvir

Offline todd123

  • Member
  • Posts: 67
  • "You don't ask, you don't know."
Re: 99.99% VL drop after only 2 Weeks Treatment. But.....
« Reply #11 on: September 04, 2008, 03:43:01 pm »
Thanks so much risred.  I really appreciate all that great info.
Tested HIV+ July 28, 2008
CD4 16 VL over 400,000
Started Prezista/Norvir, Isentress and Intelence; Mepron
8/08   CD4 64    2%      VL 1500
9/08   CD4 135  6%      VL 371
11/08 CD4 104   9%     VL 156
12/08 CD4 161   9%     VL 400
01/09 CD4 109   7%     VL 351
02/09 CD4 218   8%     VL   98
03/09 CD4   80   5%     VL   98 at least that's the same
04/09 CD4 150   7%      VL 100
05/09 CD4 232   8%      VL   90

 


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