What is goal of Atripla?

[squaw]

I need a clearer understanding of what Atripla is supposed to do.  From what I understand, it stops the virus from replicating, meaning it decreases the VL.  What about CD4 count?  My son's VL went down significantly, but the CD4 count only went up a little (280 to 370).

Just wondering what others have experienced.  We are only 5 weeks into meds at this point.

Thanks again,

Squaw

[Miss Philicia]

The goal of HIV medication is to decrease the replication of the virus to levels which are not detectable.  Increases in cd4s are an indirect result of this process, and are often a delayed response.  The fact that your son experienced an increase of almost 100 cd4 when he started out at 280 (a low number, though not a miserably low level, to start from) isn't at all shoddy after five weeks, in fact it's entirely something to be cheerful about.  Many patients take much longer to see such an increase.

Also, don't expect it to increase by 100 with each lab draw.  It's entirely plausible to reach a sort of plateau with cd4 numbers and stay there for years, and then later see them begin to go up again.  It's all part of how the body rebuilds its immune system and it's wildly variable from patient to patient.

[mecch]

Since your son is in the very beginning of HAART treatment, you could conceive the goal for the time being, to stop the replication of HIV, and him to become undetectable.  The immune system rebuilds itself in its own due time, and his experience will be unique to him.  HAART does not rebuild the immune system, it just blocks HIV replication.

modified:  Posted concurrently to Miss P's, sorry for the repeat. 

He'll do well, be patient!

[newt]

Your understanding is correct, it stops the virus from replicating and decreases the viral load. Every '0' off your son's viral load means a 90% reduction in the volume of virus.

The target is a viral load of 50 copies/mL or less.

Then the body gets rid of the trash. Quite quickly to start with, for parts of the body that are easy for the drugs to reach.

The pressure of the drugs puts the rest of the virus to sleep in time. This takes a few weeks to several months.

In time, your son's CD4 count will rise, hopefully, but it is in time, it may be quick, it may be several years.

In addition to stopping the virus replicating and destroying your son's immue system, thus allowing opportunistic infections to take hold, stopping the virus reproducing also reduces immune activation, which reduces the risk of heart disease, cognitive impairment and other things related to inflammation.

Hope this helps.

- matt

[Realist]

I need a clearer understanding of what Atripla is supposed to do.  From what I understand, it stops the virus from replicating, meaning it decreases the VL.  What about CD4 count?  My son's VL went down significantly, but the CD4 count only went up a little (280 to 370).

Just wondering what others have experienced.  We are only 5 weeks into meds at this point.

Thanks again,

Squaw

Squaw, we've been trading posts for a while - I'm happy to be your barometer!

Check my numbers out in my signature. They aren't too dissimilar. I have had a fantastic response to Atripla as far as VL goes and I'm very pleased about that. I really wished and hoped (I don't pray!) that my CD4s would also be moving quicker, but if its one thing the guys have taught me on here, is that this bit is the part that is unique to us all. I too had CD4s of over 200 but less than 300. Your son's numbers are going the right way and his CD4 response is great at this stage (certainly slightly better than mine as I have only just cleared 300).

I can't say I don't too get anxious but I believe we need to be patient and I'm willing to give it a shot. What you should also know is that even with not fantastic CD4s, I've not yet taken a day off work with HIV (and I do 12 hour days min with all the other usual life stuff thrown in on top) and I can live the life I've always lived. We'll get there.

[JJ80909]

Squaw,

I started Atripla at the end of May, and, as of this week, my VL is now undetectable and my CD4 has increased from 190 to 270. And, I haven't had any of the side effects reported with Atripla -- lucky for me!  Meds do take time to be effective, and to kick start the immune system.  HIV is a life long affliction, and with adherence to the meds, one's quality of life is definitely, in my experience, improved!  I can't tell you the anguish I went through since being diagnosed, but seeing the repair work (as evidenced by my recent labs) has made my outlook and disposition so much greater.  The numbers show your son is responding to Atripla -- keep up the adherence -- it looks like your son is responding well to Atripla.

JJ

[Dsd09]

My son's VL went down significantly, but the CD4 count only went up a little (280 to 370).

That's not a bad result at all, it's taken me 6 months to get to 370 (from 249) and my partner to 369 (from 280) - we've both been undetectable from 4 weeks 

As others have said, with good adherence the virus should stay suppressed and CD4's will increase in their own time

Personally, we're hoping to break the 400 barrier on the next visit - and hopefully your son too

Onwards and upwards