Regulars: Column

Simon Mwendapole

Treatment switch

Every day is a learning day says Simon Mwendapole as he adjusts to his new treatment regime.

It feels good to be back writing this column in Positive Nation magazine and also survive 2007. A lot of things have changed affecting people’s lives since my last article in the magazine. But the virus hasn’t changed and still lives with us 24/7. It’s the same virus though with different serial numbers and number plates.

Change is good provided it doesn’t look to disorganise or take away certain provisions or privileges that people have been accustomed to. Some time in 2006 people were being asked to consider changing their current regimen and I was one of them and I know of many others. In my opinion there was nothing wrong provided the change didn’t affect one’s general well being such as new side effects, dropped CD4 count and others that were stable in the previous regime.

As I said I was one of them that eventually agreed to switch to a new regime after being on the previous one for almost 7 years. This new one I am on is good and quite simple as I only have take once daily and mainly at night. It consists of 1 tablet of Truvada (Emtricitabine Tenofovir Disoproxil) and 2 tablets of Nevirapine. It enables me to do most things that ‘men’ do as it is so easy to manage and the packaging is excellent especially when traveling or sleeping over elsewhere.

My only concern is the dropped CD4 count from a stable 500 plus to under 400. I know to some this might sound like I am playing games as many struggle to reach the 500 plus but this is the reality. Upon diagnosis and starting of treatment, I am sure we all aim to build our CD4 count to high and very high levels this is why I am concerned. I also want to think that since diagnosis I set myself very high standards and expectations for me to attain a certain quality of life with the virus. But I must say not all hope is lost.

A few times I raised this issue with my able Consultant and others during routine monitoring or walk- in clinic, they assured me that there was nothing wrong to worry about as long as my viral load continued to be undetectable. Mine has been undetectable for over 7 years but recently I had a chat with 2 colleagues on treatment and admired the fact that they were both over 700. The woman was over 800 and the man slightly over 700 and this made me feel like there was something missing in my ‘treatment equation’. When I decided to pursue why my CD4 wasn’t rising fast, I was told there could be other factors. I also noticed that most of last year I had violent colds for the first time though I had received my flu jab. This I strongly felt could have contributed to my CD4 count not rising to my desired levels of at least over 600.

I am now watching myself to see whether without the violent colds and other factors such as stress, my CD4 will go up. If it does go up significantly I will be the happiest guy around as I have coped well and gotten used to it. But if there will be no improvement then I will be worried and will try to switch to another.

For me this is a big issue because ever since my diagnosis I have never experienced these terrible colds or flu (malaria-ish) and I am beginning to thinking it could be due my dropped CD4. Obviously with a high CD4 count one’s immunity is better placed to fight off bacteria and other infections. I am now so scared of catching a cold such that on a bus or the tube if I notice someone near me sneezing and blowing his/ her nose I tend to struggle with my inhalation.

For me all this has been a learning experience as in HIV every day is truly a learning day. People being asked or encouraged to switch medication should carefully ponder whether it’s really in their best interests to change to another regime. The factors to be considered should be likely side effects, likely benefits of an increased CD4 with the new medication and how this might affect their lifestyle. It’s also important to search for important information about new treatment of medication you are about to switch to before finally switching. In my early days of switching I experienced nagging headaches and was only told and counseled by my caring woman that it could have been the ‘switch’ but would disappear after a short while. For sure the headaches disappeared and I realized that I had some how taken treatment for granted by not researching much on the expected side effects.

The weather seems to be improving outside let me leave you now and catch some fresh air outside alone…….bye. PN

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