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Author Topic: Starting meds with no resistance test.  (Read 1889 times)

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Offline tommy246

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Starting meds with no resistance test.
« on: October 31, 2009, 01:41:53 PM »
I am 49yo male from uk living in spain,where all hiv treatment and meds are done free through local hospitals and mine say that they dont do resistance tests as only 3 % in this region have problems and these would show up if meds dont work ,should i get tested private and pay for it ,how important is it ?
The doc tells me its time to start meds i am prepared he offered atripla ,i asked about issentress truvada as i have read good things about it, he said its no better than atripla and  adherence is easier with atripla as its 1 tab once a day,do you agree ?
I think its time to start do you ? my brief history.
Jan 06 neg ,july 08 shingles,dec 08 tested pos with cd4 505, %16 vl 2.500
June 09  cd4 535 % 17 vl 80.000 (60.000 april 09 rest same)
aug 09  18 days hospital pnuemonia  cd4 190 %15 vl 225.000
aug 09 (1 WEEK LATER ) cd4 415  %20
Oct 09  cd4  591, vl 59.000,14.85 %.
He said due to my vl being quite high for so long and is also concerned with( low % 14 equals 200 cd4)its time to start i agree as iam alwats tired,low energy levels.
Last question is it unusual to have such high cd 4 and low %. thanks.Due to start on monday if i dont do private resistance test.

jan 06 neg
dec 08 pos cd4 505 ,16%, 1,500vl
april 09 cd4 635 ,16%,60,000
july 09 ,cd4 545,17%,80,000
aug 09,hosptal 18days pneumonia cd190,225,000,15%
1 week later cd4 415 20%
nov 09 cd4 591 ,vl 59,000,14%,started atripla
dec 09  cd4 787, vl 266, 16%
march 2010  cd4 720 vl non detectable -20  20%
june 2010  cd4  680, 21%, ND

Offline onemoretime

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Re: Starting meds with no resistance test.
« Reply #1 on: October 31, 2009, 01:52:35 PM »
i don't know about resisntance issues, i have also asked my doc about truvada issessence (what ever the spelling) he said the same think your doc said.. he said atripla is best and it has been working for me undectable for 4 years.. so i am not going to question it anymore...  good luck. sorry you had the hospital stay,  i had pluracy and was home sick for 3 weeks after just a year of being pos.  I was not on meds yet.  no problems since.
08/04 diag 490 cd4 vl 50,000
10/25/05 436 50,513 hvb 1.1 billion
12/13/05 truvada sustiva
02/16/06 742 und, hpb 63,000
04/27/06 740 und hpb 60,000
01/05/07 458 und hvb und
03/08   470 undetectable still on atripla. Non smoking (chantex)
08/08 cd4 550 undetectable hiv, Hep B UND. Atripla
06/09  cd4 444, vl undetectable testo 130
09/09/09 CD4 687 46% UND  Testo 213 started androgel
10/12/09 cd4 682 46% und testo 597
01/12/10 cd4 842 48% und testo 434
041010 cd4 693  53% testo 492
100410 cd4 568 48% testo 523
012711 cd4 523 hcv 56 testo 596
083011 cd4 280 Hcv/HIV und
042912 cd4 158 hcv /hiv und, was on hep c for 11 months. do have ssdi filed and getting LTD
061912 cd4 151, bactrum, hep c and hiv und
071712 cd4 287 52% HIV HCV und
112012 cd4 520

Offline StacheBC

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Re: Starting meds with no resistance test.
« Reply #2 on: October 31, 2009, 02:26:03 PM »
Being on treatment for just 3 days myself Sustiva/Truvada (Atripla). I'm far from being an expert. So please read this as my personal point of view.

Personally I would feel more comfortable getting a resistance test. Starting meds no matter how well you do on any combo can be a little stressful for anyone (even if you have little or no side effects). Not having to worry about resistance to a combo you are getting used to (even if the chances are very slim), in my opinion removes a concern from the equation.
In British Columbia, Canada resistance testing is basically mandatory now and free of charge to be able to receive free meds.

In my point of view Atripla is very popular for several reasons (one reason because it's once a day... one pill option. Although other once a day regimes are available). Yet due to its popularity it's natural that some people have a real hard time with this combo, just remember for every post of someone having a hard time with Atripla, to the point they have to switch combos... there will be many more people you'll never hear about because the side effects are in line with other current popular HAART combos and are fairly tolerable, after a period of adjustment that can vary from person to person.

Best wishes and please keep us posted.

Offline ruralguy

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  • Posts: 141
Re: Starting meds with no resistance test.
« Reply #3 on: October 31, 2009, 02:58:07 PM »
I've been on Atripla for about 9 weeks.  I got to undetectable in just 3 weeks.  The side effects were minimal (I woke up feeling like I had a bad hangover) and disappeared after 2-3 weeks.  In fact, now I take it in the morning when I get up but I recommend you start with a bedtime routine.  But some people don't have as easy a time with it.

Compliance is the key to success with all these meds so 1 pill once a day was pretty convincing.  I travel a lot so having several pills, even once a day, is a complication.  Insentress/Truvada would be my second choice but it is a 2x a day regime at the moment (this may change)

That said, there are other excellent drugs so if Atripla doesn't work for you, don't worry.  You can switch to something else. 
tested positive June 19, 2009
7/3/09 vrl 9000 cd4 - 300
8/14/09 cd4 - 350, 20%
started Atripla 9/14/09
10/5/09 vrl undetectable, WOW so fast!
12/28/09 vrl undetectable, CD4 - 615  27% cholesterol down, kidney function normal
4/26/10 vrl undetectable, CD4-600, kidney and liver numbers normal
9/9/10 vrl undetectable, CD4-685
1/3/11 vrl undetectable, CD4-700
all 2011 and Jan 2012 visits vrl undetectable CD4 ranged from 715-645
5/7/2012  vrl undetectable, CD4-615, all liver, kidney, lipids, heart functions, etc normal

On Atripla:  "Your mileage may vary"

Offline madbrain

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    • My personal site
Re: Starting meds with no resistance test.
« Reply #4 on: October 31, 2009, 03:17:25 PM »
That said, there are other excellent drugs so if Atripla doesn't work for you, don't worry.  You can switch to something else. 

The problem is that if you have resistance to one or two components of Atripla, you won't go to undetectable, and you may grow some resistance to the other components that you didn't have already. This may reduce your medication options later on.

If I were in the OP's shoes, I would pay for the resistance test.


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