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Author Topic: More Than Surviving...  (Read 919 times)

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Offline TexasDragon

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More Than Surviving...
« on: October 28, 2019, 08:34:32 am »
Just clocked 6,000 miles on my bike since diagnosis less than a year ago. Lot of miles to pedal.

Life goes on - health is good.

On Biktarvy for a year in December - ID Doc wants to switch me to Dovato in January. Says two-drug combo is better than a three-drug combo.

Thoughts?
Exposure 10-04-2018
Dx 11-08-2018
1st Appt 11-15-2018
11-15-2018 Blood Draw - CD4 468 11% VL 316,000
2nd Appt 12-04-2018 - Hep A and B Vaccines
Start of Biktarvy 12-14-2018
3rd Appt 01-15-2019 - All Good - 2nd Hep B Vaccine
01-16-2019 Blood Draw - CD4 934 28% VL 98
4th Appt 04-16-2019 - All Good - Final Hep B Vaccine
04-16-2019 Blood Draw - CD4 873 30% VL <20
01-13-2020 Blood Draw - CD4 1064 34% VL <20

Offline Jim Allen

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Re: More Than Surviving...
« Reply #1 on: October 28, 2019, 08:55:27 am »
Personally, I would tell my Doc unless there is an issue why switch? It's working, not having any issues and nothing I've seen or read shows Dovato is superior to Biktarvy treatment wise

Ultimately the choice is yours, Dolvato is a combination of Dolutegravir and Lamivudine.  I'm happy with Dolutegravir but I have to say it's not everyone's cup of tea.

Quote
Life goes on - health is good.

Glad to hear it.  :)
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Offline leatherman

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Re: More Than Surviving...
« Reply #2 on: October 28, 2019, 11:04:23 am »
thoughts as someone who isn't a doctor or medical expert:
Says two-drug combo is better than a three-drug combo.
personally as a long term survivor I believe if it isn't broken (it works and there aren't any side effects) then don't fix it. this change won't reduce the pill burden, will it reduce the pill cost? there may be little upside to changing imho. Also I looked up Dolvato and noticed a couple items, I would consider. 1) this drug just got FDA approval in april 2019, so it's pretty new. (personally I'm not a fan of brand new meds unless all other options are out. but I'm just a cautious sort of guy)

and 2) I don't know the exact scientific meaning for "treatment naive" but you have been treated with a 3-drug regimen already. I would suggest finding out more about people who have been on a 3 drug regimen and switched to a 2 drug regimen, as that is a recent treatment consideration.
Quote
“Currently, the standard of care for patients who have never been treated is a three-drug regimen. With this approval, patients who have never been treated have the option of taking a two-drug regimen in a single tablet while eliminating additional toxicity and potential drug interactions from a third drug,” said Debra Birnkrant, M.D., Director of the Division of Antiviral Products.
https://www.fda.gov/news-events/press-announcements/fda-approves-first-two-drug-complete-regimen-hiv-infected-patients-who-have-never-received
leatherman (aka mIkIE)


chart from 1992-2017
Tivicay/Prezcobix

Offline BlueMoon

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Re: More Than Surviving...
« Reply #3 on: October 28, 2019, 01:32:56 pm »

Thoughts?

TexasDragon, my thought is that I would not change a successful and stable regimen unless there is a clearly demonstrable benefit to doing so.  Good reasons to change are virologic failure, undesirable side effects, high cost and unavailability.  I suggest that you insist that your doctor specify how a change will benefit you, especially as your post and sig seem to indicate that Biktarvy is working well.

To use myself as an example, in January I switched to Biktarvy after ten years of Truvada because my BUN number has long been at or slightly above the upper limit of the normal range, and I am hopeful that the reformulated tenofovir will be kinder to my kidneys.  The change to one-pill-once-a-day dosing is a nice bonus but was not a decisive consideration.
It's a complex world

Offline leatherman

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Re: More Than Surviving...
« Reply #4 on: October 28, 2019, 06:26:21 pm »
leatherman (aka mIkIE)


chart from 1992-2017
Tivicay/Prezcobix

 


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