Recommended treatment for first timers

January 1, 2008

What is the recommended HAART treatment for people that have not been on treatment beforeaccording to the CDC and U.S. Dept.of Health? Re: Would you stay off meds if your T-Cells went under 200?

Just noticed this message. So to follow up on a previous reply to your

previous post, Dr. cacrcoastal here recommends getting on some sort of

anti.retroviral program right away. If you haven't taken anything yet,

then you are in a good situation to get some of the best meds yet.

Provided you don't have any allergies and such, my doc has me on one

truvada and two viramune per day, which I take before bedtime.

Actually hepls put me to sleep! My viral load is undetectable.

Note, from STI's discussion before. Rebuilding your tcells to above

the 400 range could take quite a while. Maybe a year. It's something

to be aware of. So if your viral load is at 93,000 now, you best get

going with it. All it takes is one OppInfection and you'll wish you

were dead.

Other side note: Other people have tried to 'disable' themselves by

staying off meds for quite a while. Or goingout and partying till they

drop, just so they could get disability benefits. Today, with all the

success, it really isn't a possiblity until you are literally on your

death bed.

Did you say you JUST became positive?? How can this be?

I know that upon infection, viral load tends to be higher at first, but

frankly, mine have never been that high, (though close...).

Also, if you could reply back just to let me know you are not a 'spy'

of sorts. Lots of anti.hivers lurking the online groups these days

making phoney stories. Suddenly, your story is having a few, may I

say, 'cracks'....

Be Well,

MX

>

> If you are healthy with no OI's and not sick and your T-Cells

> went under 200 did you always go on meds or are those that

> stayed with their natural therapies to keep them well? I'm

> struggling with that now and need to decide what do do because

> I'm not sick and not on meds but my T-Cells are between 150-200

> with viral load at 93,000.

> Am I crazy for not going on the meds yet?

> Thanks for your thoughts.

> JT.

>

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January 2, 2008

:

You have many good options for initial treatments HIV now, as many people who replied to your earlier post said. Your initial regimen should be able to suppress the virus effectively, bringing it down to undetectable levels in a fairly short period of time, allowing your t-cells to begin increasing in number, taking you out of the danger zone for opportunistic infections that many have warned you about

The US Department of Health and Human Services released updated guidelines a month ago on when to start HIV therapy and which treatment regimens to use for anti-retroviral naive patients -- those who have never been on therapy. The report is written more for doctors than for patients (it uses the chemical names for drugs instead of brand names, for example), but it is a good place to find what the consensus is of leaders in research and treatment of HIV. http://aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL.pdf

Picking an initial drug regimen should definitely involve discussion between you and your doctor about a number of factors, including how good you think you will be about taking doses on time, whether food restrictions (certain drugs should be taken with or without food) matter to you, how many pills and doses per day you can manage, and possible side effects you may be willing to risk and/or tolerate. Your doctor should do resistance testing before prescribing an initial regimen, and should run certain other tests to determine which drugs might be appropriate for you, such as tests for hepatitis A, B and C, and blood tests for kidney and liver function. Your doctor should take time to discuss all of this with you before the two of you decide on an initial drug regimen, but if he or she doesn't ask, you should be ready to ask about some of these issues.

Although there are minor risks with all medications, it is important to understand that these risks are much less significant than the risk of allowing your HIV disease to go untreated.

The government panel recommends a number of different initial regimens. Probably the easiest to take in terms of pill burden is Atripla, which is a one pill a day combination of Sustiva and Truvada, itself a combination of Viread and Emtriva. Potential risks include weird dreams and insomnia from the Sustiva and potential kidney damage from Viread, not usually a problem unless you have pre-existing kidney disease. Another alternative in the same class (NNRTI-based regimens) would be Viramune plus Truvada, which can also be taken once daily

There are a number of possible protease inhibitor-based regimens, with Reyataz, Norvir and Truvada being perhaps the easiest to take, since it can be taken once a day, and is the least likely of the PI-based regimens to cause increase in lipids (ie, cholesterol). Other possibilities include Kaletra and Truvada or Lexiva, Norvir and Truvada.

An alternative to Truvada in any of these regimens would be Combivir, which combines Retrovir (AZT) and Epivir. AZT has been known to contribute to loss of fat in the face, arms and legs, so many doctors and patients prefer to avoid it.

Your doctor will probably recommend a treatment regimen to you after getting the results of resistance and other tests, and after discussing with you the pros and cons of each option. The important thing to realize is that many good treatment options are available to you, and if you can't tolerate one drug, others are available. Also, taking HIV medications is much less risky than not taking them for you. You man even start feeling better pretty soon after starting medications, as you may be experiencing some problems as a result of your low t-cell count.

Good luck and take care,

Re: Would you stay off meds if your T-Cells went under 200?

Just noticed this message. So to follow up on a previous reply to your previous post, Dr. cacrcoastal here recommends getting on some sort of anti.retroviral program right away. If you haven't taken anything yet, then you are in a good situation to get some of the best meds yet. Provided you don't have any allergies and such, my doc has me on one truvada and two viramune per day, which I take before bedtime. Actually hepls put me to sleep! My viral load is undetectable.Note, from STI's discussion before. Rebuilding your tcells to above the 400 range could take quite a while. Maybe a year. It's something to be aware of. So if your viral load is at 93,000 now, you best get going with it. All it takes is one OppInfection and you'll wish you were dead. Other side note: Other people have tried to 'disable' themselves by staying off meds for quite a while. Or goingout and partying till they

drop, just so they could get disability benefits. Today, with all the success, it really isn't a possiblity until you are literally on your death bed. Did you say you JUST became positive?? How can this be? I know that upon infection, viral load tends to be higher at first, but frankly, mine have never been that high, (though close...).Also, if you could reply back just to let me know you are not a 'spy' of sorts. Lots of anti.hivers lurking the online groups these days making phoney stories. Suddenly, your story is having a few, may I say, 'cracks'....Be Well,MX>> If you are healthy with no OI's and not sick and your T-Cells> went under 200 did you always go on meds

or are those that> stayed with their natural therapies to keep them well? I'm > struggling with that now and need to decide what do do because> I'm not sick and not on meds but my T-Cells are between 150-200> with viral load at 93,000.> Am I crazy for not going on the meds yet?> Thanks for your thoughts.> JT.>

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January 2, 2008