Tomorrow is the day!!

[Ac75088]

Started Atripla two months ago and tomorrow I have my appointment to get my first lab results from my doc..VL was over 200,000 when I started..Not sure if I will be UD so soon but I'm lookin forward to seeing a much lower number..First time I'm actually excited to go to the doctor hehe! Happy 4th of July everyone

[buginme2]

Good luck!! Don't be discouraged if its not UD.  250k is a pretty high viral load to go undetectible in 60days, but its possible.  I'd definately expect to see if much lower. 

[eric48]

You live in a condo. In the apartment above you, your neighboor had left the bathtub tap open.

the bathtub has no stopper on the drain, but the water fills in so fast that it is full of water.

HE closes the tap (but you do not see how well he does that...)

YOU monitor the water as it flows through the drain pipe.

when you can't hear any water through the drain it means:
- the bathtub is empty (yet not dry)
- the tap is successfully (enough) closed

the time it takes for the sound for water draining to become inaudible depends on:
1 - size of bathtub (number of CD4 infected prior to meds initiation)
2 - height of bathtub (VL realeased by an infected CD4 as it dies)
3 - diameter of drain (life expectancy of a CD4, now that the fire is being extinguished)

does not depend on:
- how hot the water was (nastiness of the virus)
- how tight he has closed the tap (as long as has has closed it well enough)

on the other hand if it remain still faintly audible for way too long or very audible even after a long while, then it means the tap is not closed.

How long it takes to become UD does not really matter, as long as you get there...

1 and 2 were pretty high when it started, 3 is unknown... So it may take it time.

The above is merely an analogy but I hope it helps understand and live with what ever pans out

Eric

[WillyWump]

Good luck AC! Let us know how you do

also, dont be the least bit discouraged if you are not farther along than you thought you would be. Everyone is different, and it took me a year to go UD starting with a 100k vl. Some peeps go UD quick some take their time.

-Will

[mikeyb39]

Good luck AC, i'm sure you will be close if not already there.  My VL was off the map now that i look back at my original test. Wow, but that was taken during my seroconversion, sick as a dog.  keep us informed on how it goes.

[phildinftlaudy]

Good luck tomorrow --- here's hoping for a low viral load --- like others said, it may take a little while to get down to UD...

I am going to hedge a bet and say it will be down to around 3,000 or less....

Which would still be great ---- I started meds with a fairly low VL and it still took about 6 months to get it UD.

Looking forward to the update.  

[Rev. Moon]

I'ma use my Dionne Warwick psychic skills, and predict that you will actually be undie.  

We all know everyone is different, but if I could go from 1.5 million to UD in just over three weeks back when I started then you might do it in two months.  For sure it will be somewhere near the low end of the spectrum.  Good luck, child.

[WillyWump]

My prediction is ...... 50k

[phildinftlaudy]

The person who gets closest to guessing Ac's viral load number will win........._____________.

[WillyWump]

The person who gets closest to guessing Ac's viral load number will win........._____________.

...a BJ from Phil. If it's a girl then they get a little tongue action down there from Phil.

[phildinftlaudy]

...a BJ from Phil. If it's a girl then they get a little tongue action down there from Phil.

I'm game 
Oh, and for the ladies --- I can touch my nose with my tongue  (Gene Simmons from KISS style)      and can go long time --- since nothing else would be likely to occur other than that. 

[Rev. Moon]

Oral is not mah thang.  When I win you can give my prize to the runner-up.

[WillyWump]

Oh, and for the ladies --- I can touch my nose with my tongue 

ewww. you nasty!

[Ac75088]

LOL!! Y'all are a trip...I'm so glad my VL could spark up such a contest

[wolfter]

How many votes do we each get?  I really want the grand prize.   

I'm betting UD!  I went from 6.7 mil to ud in 14 months so anything is possible.

[Betelgeuse]

I'm actually waiting for my one-month follow up tests as well.  My doctor said that he doesn't see a need to test my CD4s at this time (something I was a bit disappointed about).  He doesn't expect that number to have changed so drastically in the month I've been taking my meds.  The important thing right now is for us to see a downward trend in our viral load levels.

My doctor said for the month that I've been on treatment, I can expect my viral load to have decreased by a factor of 10.  (i.e., 7,500 now becomes 750).

Good luck and happy belated 4th to you.

[Ac75088]

Well 2 months of treatment and my cd4 went up to 585 and my vl is 550..My doc was actually not happy I wasn't UD yet and even asked me if I was taking my meds every night, which I have been...And even though I underwent 2 weeks of IV penicillin in the hospital, he gave me a cement shot in the ass 'just to be on the safe side'..Now I gotta walk around funny all day...oh well..At least my numbers are improving everywhere

[Rev. Moon]

Well 2 months of treatment and my cd4 went up to 585 and my vl is 550

You're doing very well, almost there.  Don't let the doc rain on your parade. 

[eric48]

My doc was actually not happy I wasn't UD yet and even asked me if I was taking my meds every night, which I have been...

the US guidelines are quite vague about VL decay, at least the requirements are not as strict as they are here where I live. They are , as far as I have learned so far on this matter the most restrictive.

here they are

CHECKPOINTS
***********
Here, targets are
- decrease of 1 log after one month
- decrease of 2 log and/or < 400 after 3 months
- <50 after 6 months

At month 2 my VL was around 600 and my doc was nervous about it. He ordered an additional resistance test (which would still be feasible at your 500+ VL); the resistance test came back unchanged.

(see here:
http://forums.poz.com/index.php?topic=33062.msg424102#msg424102
)

those 'strict' guidelines had been established at a time where the recommendation was to start meds around cd4 count = 350. If people are going to start at higher CD4 counts, they will have to adjust (ease) accordingly...

Because I have experienced a slow decay myself, I had carefully mentioned to you that this might happen
(your VL/CD4 count at initiation being quite similar to mine)

Do not over stress it, then.

If you have the opportunity, and feel uncomfortable about this VL (here), a VL test costs about $ 50... you may want to have a test at month 3 sharp (at your own cost) and if < 400 (which it most likely will be) you would then be within the above mentioned checkpoints (which are not the most liberal by any means...)

That is, if you feel uncomfortable about your VL... because, I, for one, would sympathize with that feeling but my humble opinion is that this VL is still in line with expectations/guidelines.

Hope this helps

Eric

[newt]

550 at 2 months is a stunning result. To reach below 50 from there can take up to a year, tho most do it within 6 months.

All the best

- matt

[WillyWump]

Remarkable results! Not sure why your doc was put off by the results, they seem pretty damned good.

Congrats!

-Will

[Ac75088]

Thanks guys!! Well I guess nobody gets the "grand prize" lol

[phildinftlaudy]

Thanks guys!! Well I guess nobody gets the "grand prize" lol

We could always go for best out of 3 -- or the 3 who were closest --- have knee pads, will travel.

[Ac75088]

We could always go for best out of 3 -- or the 3 who were closest --- have knee pads, will travel.

Well I think since it's my post I should get one anyway

[phildinftlaudy]

Well I think since it's my post I should get one anyway

Oh, that was a given - after everything you have been through, it is the least I could do....

[Ac75088]

Oh, that was a given - after everything you have been through, it is the least I could do....

woohoo!! If I'm satisfied I just might return the favor!

[phildinftlaudy]

woohoo!! If I'm satisfied I just might return the favor!

Hey,that sounds like a plan -
just have to wait for my syphilis titer to come back -- lol - or you'll be getting more cement butt shots.....

If we both would have been in the hospital at the same time, same hospital, same room..... hmmmmm, that would have been interesting to say the least.

[funkycj]

gud luck with your results hope your VL has dropped, i am starting the same meds next week very nervous but hoping it will improve my health , hope all goes well

[Ac75088]

gud luck with your results hope your VL has dropped, i am starting the same meds next week very nervous but hoping it will improve my health , hope all goes well

Thanks! I also hope the best for you..Keep me updated

[Imfree76]

Glad to hear your doing well.  I haven't stuck to my meds the way I should.  Dr's appointment later in July. Just going through a bout of depression right now. 

Talk to you all soon.

John

[Ann]

Glad to hear your doing well.  I haven't stuck to my meds the way I should.  Dr's appointment later in July. Just going through a bout of depression right now. 

Talk to you all soon.

John

John, if your adherence issues are due to how you feel in the mornings, it may be time to explore other combo options. Did you ever get a resistance test after having to stop the Atripla due to the severe rash you had?

[Imfree76]

Ann-

I never got a resistance test and he told me to start back on the Atripla.  I'm just at a point I think where I am torn on whether to take anything or not.

[Ann]

Ann-

I never got a resistance test and he told me to start back on the Atripla.  I'm just at a point I think where I am torn on whether to take anything or not.

The numbers you started with indicated an infection of some years standing. Your CD4 was in the 100s. It would NOT be a good idea for you to go without meds. You need to talk with your doctor about a combo change rather than stopping completely. Unfortunately, you don't have the luxury of stopping completely. Not unless you want to get really sick and die, that is. Sorry to be so blunt, but that's the way it goes.

[eric48]

Ann, john,

with all due respect John's post are a bit alarming and would deserve a new thread as john's reported problems are not in line with the OPs ...

John, people here are not doctors but can help you with their personal experience.

We do not know much about your infection history and you will find a lot of usefull information on this site.

IMHO, YOU NEED HELP!...

you said :
I never got a resistance test and he told me to start back on the Atripla...

At CD4 in the 100s, your are in the 'red zone' that requires very close follow up and attention.

It requires prompt action. If you were given medication without a resistance test, this is NOT in line with the DHHS guidelines.

read:

http://aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL.pdf


The resistance test is a MUST HAVE (see guidelines page 11)

-----
Panel’s Recommendations:
• HIV drug-resistance testing is recommended for persons with HIV infection when they enter into care regardless of whether antiretroviral therapy (ART) will be initiated immediately or deferred (AIII).
------

a resistance test takes 3 weeks (it is a manual and lengthy, work intensive procedure)

Your doctor may have ordered the resistance test and you may have not been aware or he/she way have felt and urgency not to wait for the results.

If you have been recommended a medication that does not have a very high barrier against genetic mutations ( and Atripla somewhat falls into that category) without a resistance test, there is still time for action ! the resistance test (if indeed has not been performed) can still be performed on the stored blood samples.

Some regular posters on this forum (other than myself) (who are not doctors) but have helped lots of people with sound advice would be more than happy to help you prepare for your next doc visit

If  you :
- have not had a resistance test
- have been prescribed Atripla (before the resistance test results are known)
- have not been 100% adherent (due to adverse effects or depression)

you might:
A - be lucky and resuming treatment religiously may help you reach the ultimate goal of treatment (stamping down the virus and resuming good health)

But you might as well
B - be calling for problems (resistance) that are not easy to sort out

As I do not live in the US, I would not know what your options are (second medical opinion, support group, case mangers, what have you...)

PROPER management of the infection/disease leads to VERY GOOD outcomes. The virus is nasty and is not forgiving for leniency.

Lots of people on this planet do not have access to PROPER management or meds.

but you live in the US ! You have all the tools at hand to be successfull.

Sounds to me that you need someone (other than your doctor) to help you very closely during the coming months.

Wishing you the best !

Eric

[buginme2]

Agreed, alarming.  What is causing your adherence issues? Are you in the U.S?  Have you contacted an ASO to get some support?

[hubsen]

I hope that you'll get the same results as I did. I started on Atripla on June 6th and I had my first lab made two days ago. Check my signature for the results! I couldn't be more happy today!

[Ac75088]

I hope that you'll get the same results as I did. I started on Atripla on June 6th and I had my first lab made two days ago. Check my signature for the results! I couldn't be more happy today!

Very good results! Congrats! We should both be undetectable very soon hopefully! 

[hubsen]

Very good results! Congrats! We should both be undetectable very soon hopefully! 

 
That's the goal! Great results you too! Keep well 

[Imfree76]

I was given a 3 different pill combo to start tomorrow.  Thanks for all of your concern.   

J