Urgent surgery - skipping dose of Odefsey

[inlove]

Hey,
I was rushed to hospital today due to terrible back pain. I was just told that today i will undergo lumbar discopathy surgery. I have to fast and I can't drink any liquids prior the procedure. I took my Odefsey pill yesterday with breakfast, its now thursday morning and im suppsed to take my pill but cant. Im now afraid it will fuck up my arv theraphy.

Im on ARV theraphy since 2015, always undetectable since then.

[Jim Allen]

Sorry to hear about the back pain and I hope the surgery goes well today. Please keep us posted.

As for missing the meds today, I presume your medical team knows and it doesn't make any difference.

You are on Odefsey, so triple therapy and for triple therapy perfect adherence is considered taking your meds 95%+ of the time on time. So even if you miss the odd pill it would still be ideal adherence (Not that I recommend skipping pills, if avoidable, but sometimes it happens or is needed)

Im now afraid it will fuck up my arv theraphy.

So you will not fuck up your treatment by skipping one pill today. Missing a dose for whatever reason is a common enough concern, included some previous threads on the topic as you might find them useful/reassuring.

Adherence
https://forums.poz.com/index.php?topic=73377.msg

https://forums.poz.com/index.php?topic=64111.msg

https://forums.poz.com/index.php?topic=71153.msg


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5943894/
Adherence and virologic outcomes among treatment-naïve veteran patients with human immunodeficiency virus type 1 infection

A cohort study was conducted on HIV veterans initiating antiretroviral therapies in 1999 to 2015

In summary, this study showed how initial adherence differently influenced the viral suppression rate across different regimens. No evidence shows 95% adherence threshold is necessary. Patients with medium adherence (75%–<95%) can achieve viral suppression with the rate not statistically significantly different from patients with high adherence.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4839839/
Adherence to Antiretroviral Therapy and Virologic Failure

Paterson et al suggested that at least 95% adherence to unboosted PIs was required for virologic suppression. This 95% adherence cut-off point, based on what is now obsolete therapy, has been widely used as the level of optimal adherence needed to be met by patients taking newer agents and their combinations.

This meta-analysis synthesized 43 studies (27,905 participants) performed across >26 countries, to determine the relationship between cut-off point for optimal adherence to ART and virologic outcomes.

Irrespective of the cut-off point for optimal adherence, our findings support the tenet that optimal adherence to ART is associated with positive clinical outcomes. The threshold for optimal adherence to achieve better virologic outcomes appears to be wider than the commonly used cut-off point (≥95% adherence). Though patients taking ART should be instructed to attain ≥95% adherence, apprehensions of slightly lower adherence should not deter prescribing ART regimens at an early stage of HIV infection.


https://journals.lww.com/jaids/Abstract/2019/11010/Antiretroviral_Adherence_Level_Necessary_for_HIV.3.aspx

Antiretroviral Adherence Level Necessary for HIV Viral Suppression Using Real-World Data

A benchmark of near-perfect adherence (≥95%) to antiretroviral therapy (ART) is often cited as necessary for HIV viral suppression. However, given newer, more effective ART medications, the threshold for viral suppression may be lower. We estimated the minimum ART adherence level necessary to achieve viral suppression.

Results: The adjusted odds of viral suppression did not differ between persons with an adherence level of 80% to <85% or 85% to <90% and those with an adherence level of ≥90%. In addition, the overall estimated adherence level necessary to achieve viral suppression in 90% of viral load tests was 82% and varied by regimen type; integrase inhibitor- and nonnucleoside reverse transcriptase inhibitor-based regimens achieved 90% viral suppression with adherence levels of 75% and 78%, respectively.

Conclusions: The ART adherence level necessary to reach HIV viral suppression may be lower than previously thought and may be regimen-dependent.

[Jim Allen]

Again, good luck today and keep us posted, I wish you a speedy recovery.

[Grasshopper]

I hope your surgery went well.

I've had surgeries in the past, and a bit/sip of water to take a pill was never an issue. A little bit of clear fluids like water are usually clear of your stomach within an hour.

Wishing you a speedy recovery

[inlove]

Thank you guys.
Turned out, I was able to take my pill on a surgery day, but on an empty stomach.

[Jim Allen]

Thank you guys.
Turned out, I was able to take my pill on a surgery day, but on an empty stomach.

👍

Hope the surgery went well and you are recovering quickly.

[Tonny2]

        ojo.        I’m glad you were able too take your med and hoping for a speedy recovery and remember that if you miss a dose you will be fine…hugs