HIV, LIVING WITH COMMUNITY
complete treatment failure - need med advice

complete treatment failure - need med advice

I am in Indonesia and do not have access to quality doctors to advise me.

As of July 1 2011 I was at a cd4 of 150 and an undetectable viral load.  Because my CD4 levels had continued to decline after 1 year of treatment at that time I switched from:
tenofovir 300mg 1x day, emtricitabine 200mg 1x day, raltagravir 400mg 2x day, maraviroc 300mg 2x day.
to
raltagravir 400mg 2x day, maraviroc 300mg 2x day., lopinavir 475mg/day, ritonavir 125mg 2x /day , as lopinavir/ritonavir has been said to have a history of raising cd4 over time when substituted for tenofovir/emtricitabine.
On October 20 I also added celecoxib 200mg twice a day, as studies have shown it to raise cd4 and reduce programmed cell death*.  At that time maraviroc dosage was reduced to 150mg/day

As of Nov 30, 5 months later, my CD4 is 100 and the viral load is detected at 4.95 log 10 which is about 80,000 copies per ml.

On my original regimen it had taken 10 months for my viral load to become undetectable.

I am in Indonesia and do not have access to quality doctors to advise me.

I need to know how to proceed with my drug regimen.  Should I add tenofovir and emtricitabine again, and take all medicines?  Or switch back and stop taking lopinavir and ritonavir?

Is there another regimen I should switch to?

I have not noticed any side effects from any medicines.  For one week prior to switching, I did take all of them, with no noticable side effects.

* From http://www.ncmm.uio.no/news/new-publications/an-exploratory-trial-of-cyclooxygenase-type-2-inhibitor-in-hiv-1 Celecoxib reduced chronic immune activation in terms of CD38 density on CD8 T cells (24%; P 0.04), IgA levels (P 0.04), and a combined score for inflammatory markers (P < 0.05). **Celecoxib further reduced the inhibitory surface receptor programmed death 1 (PD-1) **on CD8 T cells (P 0.01), including PD-1 on the HIV Gag-specific subset (P 0.02), enhanced the number of CD3 CD4 CD25 CD127lo/ Treg or activated cells (P 0.02), and improved humoral memory recall responses to a T cell-dependent vaccine (P 0.04).  In conclusion, celecoxib downmodulated the immune activation related to clinical progression of chronic HIV infection and improved T cell-dependent functions in vivo.
173692_tn?1334017348
No one here can advise you of your medicine regimen.
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