Advertisement
The Body: The Complete HIV/AIDS Resource
Follow Us Follow Us on Facebook Follow Us on Twitter Download Our App
Professionals >> Visit The Body PROThe Body en Espanol
   
Ask the Experts About

Choosing Your MedsChoosing Your Meds
          
Rollover images to visit our other forums!
Recent AnswersAsk a Question
  
  • Email Email
  • Glossary Glossary


Starting the treatment
May 11, 2012

Dear Sirs,

Let me first thank you all for the wonderful help you have been giving to all of us. I already asked one question and was wondering if I could ask again.

I was infected sometime in Q2-Q3 2011, diagnosed in January 2012, first lab results came in February VL 147,000 CD 472. The next test from the end of April was slightly better but not much: VL 115,000 CD 486. All remaining tests were OK as well as liver and kidney function. An untreated HAV infection antibodies were found but thats all, no STDs.

My doctor believes I might be on of the few who remain with high VL regardless the time and so I should start the treatment ASAP. Would you agree?

My first question: they found resistance to NFV, fAPV IVD, SQv and ATV. My doctor said this is a rare combination of resistances. What does that mean to me? How much are my treatment options limited now?

Secondly my doctor wants to put me on Emtriva + Viread 1 tablet daily in the morning and 1 tablet of Strocin before bedtime. Is this a good first line option? What should I look out for?

Thank you all again

M.

Response from Dr. Young

Hello M and thanks for posting.

You do have a somewhat unusual resistant virus- with pretty significant protease inhibitor resistance, but no other detected resistance. This minimally means that your future PI choices are restricted. In this circumstance (transmitted PI resistance, I'm also somewhat concerned about the rare, but possible situation of transmitted integrase inhibitor resistance- but that would depend on what country you live in and what the availability of Isentress has been. Here in the US, there have been several reports of transmitted multi-drug resistance with Isentress, but typically in patients who also had transmitted PI resistance.

As for when to start medications, in your situation, I'd agree that despite becoming infected relatively recently, your HIV viral load is high and your CD4 counts are reproducibly below 500. That would meet my criteria for considering ART-- as was the recommendation of your doctors.

The regimen that you've started (tenofovir/Viread, FTC/Emtriva and efavirenz/Stocrin) is very highly recommended and usually very well tolerated. Here in the US, this combination is often sold as the single tablet regimen, Atripla. One should be mindful of the possible side effects of the medications, typically related to the efavirenz component-- psychological or sleep symptoms- symptoms that usually improve in a few days or weeks of starting. The tenofovir component is associated infrequently, but characteristically with kidney and bone toxicity, so we're mindful of monitoring for these issues in patients receiving this medication.

I hope that's helpful. Write back anytime. BY



Previous
Please advise
Next
Haven't Started with my Med

  
  • Email Email
  • Glossary Glossary

 Get Email Notifications When This Forum Updates or Subscribe With RSS


 
Advertisement



Q&A TERMS OF USE

This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.

Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither TheBody.com nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.

Review our complete terms of use and copyright notice.

Powered by ExpertViewpoint

Advertisement