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Author Topic: When to start meds? Advice / opinion please?  (Read 1797 times)

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Offline ShadesOfGrey80

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When to start meds? Advice / opinion please?
« on: February 07, 2014, 02:37:44 PM »
Ok, so I have found out about my status just before NYE and it has been a bit over a month now. My first results were CD4 479, CD4% 28.8%, VL 3307. My doctor suggests that I start meds next time once my genotyping/ drug resistance tests are done - which would put it at the end of the month.

Now the thing is that I will be starting a new job in mid March and I will be working a lot and traveling during that time. My doc and case worker are concerned that this might be stressful and might affect my drug reaction if I don't feel well. He thinks that my current numbers are good enough to hold off a bit longer and thinks it would be beneficial for me hold off until I'm more settled at work.

Now my issue is that once I start work I won't have any leave until I'm passed probation 3 months later. So I was thinking of utilizing my time between jobs (about 2 weeks) to adjust to the meds. You guys think that's sufficient time? Or should I allot more time? Or will I be able to perform well at work? Any advice or opinions?

« Last Edit: February 07, 2014, 02:47:07 PM by ShadesOfGrey80 »

Offline geobee

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Re: When to start meds? Advice / opinion please?
« Reply #1 on: February 07, 2014, 02:52:39 PM »
There will always be "something" -- travel, work, family stress, etc.  My advice is : start your meds.  You don't want that virus running unchecked in the body.  The side effects will probably be minimal.

You have a low VL without meds.  That's great.

I'd ask another ID doc, see what they say.  I started right away after my diagnosis. Didn't like waiting, feeling nervous with each lab, etc.

Offline EUINAU

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Re: When to start meds? Advice / opinion please?
« Reply #2 on: February 07, 2014, 03:16:28 PM »
I have started my meds and travelled for work the next day and it was my new job, was in it only for couple of months...I had no side effects though...

Offline Theyer

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Re: When to start meds? Advice / opinion please?
« Reply #3 on: February 07, 2014, 04:27:27 PM »
Hi and Welcome.

Hesitate to give direct advice but will point to the healthier you are when you start the more able you are to deal with any side affects [ which are rarer now-a-days anyway ].

The point made by Geobee is a good one.

Are you a disciplined person , are you stoical with illness ?

What will make you feel safest ? are ? that could provide you with your answer.

Whatever you decide good luck with it all.
"If we can find the money to kill people, we can find the money to help people ."  Tony Benn

Offline ShadesOfGrey80

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Re: When to start meds? Advice / opinion please?
« Reply #4 on: February 07, 2014, 08:20:57 PM »
I would like to start meds ASAP to keep my VL down and CD4s high. Like Geobee said, I feel uneasy knowing that I have a virus in my body that is running wild and getting stronger by the moment.

I can't say I'm the most disciplined person in the world but I need to start and it's only a matter of when. So sooner better than later. And I am always best when I have to face a new challenge.

So I guess fingers crossed for me on no side effects! Thanks all!

Offline hivtalian

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Re: When to start meds? Advice / opinion please?
« Reply #5 on: February 08, 2014, 06:21:20 AM »
I had an acute onset, a seroconversion syndrome, so fortunately I had an early diagnosis. I decided with my doctor to start ASAP, before even knowing my viral genotype. And my values after one month are pretty good (VL 500000 to 500 and CD4  590 to 900). But just the day after I started, my psychological state improved so much! Knowing I was starting my fight against the virus made me feel so right. I wouldn't have been able to let the virus do his
Fucking job inside me. Now he knows he has to be fear his host!:)
And this apart, the last research seems to agree with a "hit soon, hit hard" way of treatment.
So I'd start ASAP, even because the side effects of the pills now should be much fewer than before...
Good luck!

Offline hivtalian

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Re: When to start meds? Advice / opinion please?
« Reply #6 on: February 08, 2014, 06:22:36 AM »
Has to fear his host*

Offline mecch

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  • red pill? or blue pill?
Re: When to start meds? Advice / opinion please?
« Reply #7 on: February 08, 2014, 06:35:49 AM »
"Hit hard" to me is a misnomer that can contribute to fear of medication. The dosages we take are the same whether we start early or later in the course of an HIV infection.

I personally do not "imagine" in my head that there is anything "hard" about HIV medicine, even if maybe there is.

Now I understand that some people see "Hit early and hit hard" as meaning - just start the treatment early, and that treatment works (hits the disease hard), so with that meaning, I'm OK.


A second observation, shades, is that you report contradictory advice from your doctor. The doctor either recommends that you start now, or the doctor recommends you wait until after you are established in your job, (maybe because of something he/she has observed in your contact).   Its either one or the other.  Which is the actual recommendation at this point?  If you haven't got a clear message, ask for clarification. 

Many times I haven't been sure what I wanted in my treatment and I simply asked for a clear recommendation and if the doc could offer a recommendation, I just took it.  Of course, sometimes the doc will explain the advantages and disadvantages of a few choices, and not really make a recommendation. 
« Last Edit: February 08, 2014, 06:37:54 AM by mecch »
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline eric48

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Re: When to start meds? Advice / opinion please?
« Reply #8 on: February 08, 2014, 08:02:21 AM »
First, you have to realize where you stand

on a 0-10 scale (where 0 is danger zone)

you are at 8-9 (immunologic) and 8-9 (virologic)

You have the virus not the disease

pannel opinions get divided on a favorable case like yours

This is a luxury not many people have

Both option seem equaly OK

As a general feeling, I did not feel sick before starting meds and have never been

sick, but now  really feel 'medicated', So I have some second thoughts about

starting too early. Note: you can always stop ! (This is a luxury not many people


So until you 'feel' the effects of infection such as fatigue, there is no rush

You are in one of those cases where you can wait

Take your time, learn but don't be complacent, do you lab test and visit your doc as precribed

Stay healthy

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 hivtalian

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Re: When to start meds? Advice / opinion please?
« Reply #9 on: February 08, 2014, 09:56:46 AM »
Mecch I agree. I didn't want to mean that pills are heavy or dangerous, actually I started with mine and no side effects at all, apart from a light rush for few days.

I just meant to kick the virus'ass:)

And to be honest, personally I think that even if one feels good without therapy, Thw virus works inside his body, and there are many studies now investigating on it. This is the reason why some doctors believe in a therapy no matter how the cd4 are.

This is a theory, only the future will tell us if it's right or wrong.
Personally, I really believe in it, and I've found a doctor who follows this theory, and put me in a clinical study on it. And I trust my doctor  very much.

The most important thing, in my advice. Therapy or not.

Good luck to everyone.

Offline Tar Heel

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Re: When to start meds? Advice / opinion please?
« Reply #10 on: March 05, 2014, 05:59:40 PM »
I was infected and diagnosed in 2005.  My doc said to wait for meds.  In 2009, my cd4 count hit 400 and he said it was time to start so I did.  No problems since and I had NO side effects..

But since then, I think studies have shown that the earlier you start meds, the better.

My personal opinion:  If your numbers are ok, wait till you see very little stress (like a new job) in the immediate 3 months and then start.
"So much has been given to me that I have no time to ponder on that which has been denied." ~ Helen Keller


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