Q and A

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I have questions regarding adherence and research….

Hi there,

First I would like to say thanks for the assistance provided on this website. All the answered questions, help, advice, and feedback is greatly appreciated.

My question (its kinda 2 questions actually) is regarding adherence, and then regarding research.

1. I take Atripla and have been respondnig to it very well thus far. I take it at the same time everyday but lets say once a month or so, when I’m out with friends I may take it about two hours late or so? Is that gonna cause any problems? I imagine it would not since I’ve read that Atripla has a good half-life and also read somewhere that Atripla can be taken up to 12 hours late (which I would never do, but just stating what I read). So for example if I take it at midnight everyday, than take it at 2 or 3 am once every month or so, I’m wondering if that will cause any problems? I have yet to miss a pill and don’t think I ever will actually, until some advanced treament comes along.

2. Second question is regarding research and future of meds, vaccines & potential functional cures. I have read about the recent breakthroughs and exciting research going on like the Dermavir patch/vaccine, the CMV vaccine that cleared SIV in monkeys, the Pro 140 once every two week injection, Sangamo’s gene therapy, the Berlin patient, etc and many other good reads. I know that me, you or anybody can’t predict the future but how likely do you think there will be some sort of big change in how HIV is treated in the next 5-10 years? And do you think there will ever be a time in the coming years where we can control the virus without the need for daily meds? Your opinion would be greatly appreciated.

Thanks a lot and keep up the good work.

What causes Sustiva to have effects on the brain?

I have been on Sustiva for a while now and shortly after taking it, I always get a feeling of being very ‘high’ and extremely drunk, to the point where I cannot stand or talk properly.

I’ve read about other people refering to the drug similar to being ‘stoned’ or on acid but as I have never experienced either of these, I was just wondering what exactly causes Sustiva to have these effects on the brain?

I understand Sustiva affects the CNS but what exactly does it do to make me feel so drunk, surely this isn’t good for the brain.

Thanks in anticipation.

How can I get my CD4 count to increase?

Hi – what can I do to help increase my CD4? I have just found out I am at undetectable level after 8 weeks on treatment which is great. my CD4 has gone from 95 to 166 (after 4 weeks) and is now 173 after 8 weeks. I know it can take time for the CD4 to recover when the base level is low as mine but I am still disheartened as I was really hoping for it to have rebounded a bit better than this. What can I do to help it increase? Many thanks for your advice.

Is my risk of HIV higher if it is my first time having sex?

My partner is HIV positive.To be safe we have avoided any penetration so far. I want to concieve now, but I need to be sure that our child would be safe from the virus.

I’ve read the suggestions on this site, however, I am not sure wheather they apply to me. I will surely tear and bleed as it will be my first time and that puts me at a greater risk of getting infected.

If I get infected while concieving, would the virus definety be transmitted to the foetus? Or do we have a chance of having a healthy child?

Please answer.

My husband just told me he is HIV positive…..

My husband told me he has HIV 2 months ago after marrying me 5 months ago.

I was pregnant had a miscarriage and he continued to have unprotected sex with me knowing he is HIV positive. One weekend I traveled out of town with the kids. He was able to have time alone to reflect on his past and the guilt of exposing himself to me.

After a while he told me he has HIV. My body felt weak, empty and then my temperature rose, I was angry. He was hoping that I loved him so much that by that time I would not leave. I felt so betrayed, stupid and foolish, and then I knew how much I do love him. I immediately stated I needed to get tested. I was so scared. We drove home and we closed ourselves in our bathroom to prevent the children from hearing me cry and cry.

The next morning I was afraid to go to a clinic……

My viral load increased in my third trimester – what should I do?

Hi,

I am in my 36th week of pregnancy and have discovered through doing some tests that my viral load has increased from less than 20 to over 19,000. I need advice as to whether it would be safe to have the baby as soon as possible and what the risks are of the baby being infected. I’m really worried as I feel the longer I wait, the higher the rsk of the baby being infected. Thank you

Is HIV causing my low platelet count?

Hello,

I am HIV with good value of CD4, ranging between 700-600 with CD4% of 25%-26%, no therapy at the moment.

The problem is that I have a very low level of platelets ranging between 50,000 and 32,000. My doctor is sure that this very low level of platelets is due to the HIV infection that is attacking them. Now, I need an advice, my doctor wants me to start HAART in order to improve the platelet count. On my side I think I still have a very good level of CD4 and would like to wait. What do you think?

Thanks a lot for your support!

What can I do about my high levels of bilirubin now I am on atazanavir?

Hi,
I am on a combination of atazanavir, Truvada and Norvir (ritonavir). Although I am happy with my current regimen, the only problem I have is hyperbilirubina. My bilirubin levels are, and have been over 6 times the maximum normal limit. My other liver function parameters are OK.

The only physically manifest symptom is the severe yellowing of my eyes. I have tried things like keeping hydrated but that does not seem to help.

Much as annoying as it is (yellowing) of eyes, I want to be on my current regimen. My only concern is are there any long term consequences of very high bilirubin on general health and health of the liver in particular.

Having HIV is a long haul and the kidneys, liver are the two principal organs where drugs are metabolises. I am concerned that this high level of bilirubin will cause irreversible damge to liver and other vital organs.

Do you think having this level of bilirubin is dangerous in the long term?

If I adhere 100% will resistance happen over time anyway?

Hi, before I ask my question, can I just congratulate you for this wonderful resource which has been of great help to me since my diagnosis.

I have recently achieved an undetectable viral load after a year on therapy. My numbers are – VL less than 40 and CD4 663 with a CD4% of 33%. In the past year I had to switch treatments due to side effects (efavirenz and darunavir based regimens). I am currently taking Reyataz+Truvada+Norvir. I am generally happy with my treatment except for very high bilirubin. I am ~ 100% adherent.

My doctor advises me that with every year of successful viral suppression, the chances of resistance continue to drop; is this true?

On a more general note, I want to know, how long can one go on a regimen with good adherence and viral load suppression? Some people suggest that one can carry on theoretically indefinitely and realistically for decades without the need to change regimen. On the other hand, some suggest the inspite of viral load suppression and good adherence, resistance will eventually develop (but it happens at a slow rate).

I understand that everyone is different but can you shed some light on this question – how long can one go on with good adherence and VL suppression on a single regimen? Are there any studies that give us more insight into the mechanisim of resistance in such situations?

Apologies for being longwinded but I believe this is an important question and there doesn’t seem to be much information around.

Thanking in anticipation. Comments from other readers would be welcome!

How can I prevent muscle wasting?

Hi,

I’ve been positive since November ’09 after seroconversion in October ’09. Since then my CD4 count has been between 500 and 700, my viral load between 20K and 50K and my CD4% has never been below 28%. I eat healthy and well, cycle every day and gym three times a week. I am not on meds yet.

My question is about pre HIV treatment and muscle wasting, to what degree of muscle wasting am I likely to suffer and how can I prevent or reduce this?

Thanks.

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