Prep Any Potential Side Effects Similar To Poz Meds

[Pitt1988]

My friend is poz, and after 2 years of taking meds ive noticed he has many nosebleeds due to high blood pressure and an odd shaped stomach, and ive noticed other poz guys with facial wasting, i wonder if prep can also produce these type of side effects; or its a combo of hiv and meds that produces these and other side effects?

[mike_thieriot]

Sure it can, as its the like 2/3 of the standard HIV cocktail. That said, the symptoms you list can be caused by other factors. You'd have to have ridiculously high blood pressure to get nosebleeds. Most likely its because of a dry climate. Bloating could be caused by bad diet and lack of exercise (as can wasting).

[Pitt1988]

He is 27 and lives in florida, so im not sure if its the florida climate? i was there when i saw the nosebleeds; and it was the scariest thing ever! i had never seen anything like it before, then however he told me the meds stopped working and he had to change meds, i couldn't believe meds would stop working so soon not even after 3 months when the doctor told him he was undetectable, he doesnt look bloated per say, it looks more like his upper body took on an odd shape compared to his lower body, i think its the fat storing and re=arranging that hiv meds do, because he does work out regularly; he does continue to have sex with the guy that infected him; so he might be getting reinfected, im not really sure, since its the same strain

[fskn]

You can find complete side effect tables, with references to all applicable studies, in the monograph glued to Truvada bottles. (It's the super-thin onionskin paper sheet that unfolds to the size of a newspaper page.)

Remember that side effects occur in a minority of patients.

It is assumed that the effects of being HIV-positive, the combined effects of the 3-or-more drug regimen needed to treat HIV (as you say, Truvada contains only 2 drugs), and the impact of other HIV medications previously used, yield different results when a positive person takes Truvada than when a negative person takes it.

[Bottomhole]

I'm positive(only recently) and haven't started meds yet. This kind of account frightens me. The lipodystrophy, blood pressure etc. It's very worrying, any time I ask my nurse about side effects of medication, she gives a vague answer about it depending on what I eventually take and about not worrying until I go on meds. Still though, it's hard not to worry. None of my friends or family know, so something like that would be a dead give-away.

Edited October 2, 2014 by Bottomhole

[fillmyholeftl]

The "physical" side effect are very rare with the newer drugs. I liken the warnings much like a lawyer you consult about the parking ticket you want to fight.. he must tell you that you could go to jail ...  Stop worrying, don't let the VIRUS or treatment define or control you.

[bearbandit]

Side effects from the newer ARVs are rare. Truvada carries with it the commonest: GI problems (which hit only about 10% of those taking it). When I was taking truvada therapeutically (we're seeing a difference in how HIV- and HIV+ men deal with truvada) I had regular bloating (nothing worse that you'd get from metformin which is the first line medication for diabetes) a little GI upset to start with: I don't think I ever threw up, but I did have diarrhoea worse than usual - I also take a couple of protease inhibitors which are notorious for causing the shits. The rule is if you throw up and see a pill in the ejecta, take another. No pill - it's in your system.

Truvada is NOT associated with lipodystrophy or lipoatrophy (maldistribution of fat away from the limbs and face respectively). Although lipodystrophy is untreatable at present, you can hide it by using an exercise regime focussed on your upper body. As a friend of mine (who is a qualified personal trainer and devised the routine for me) says "you're aiming to look like a rugby player who likes his beer: not a bad look in my book!"

It takes the drug companies years to update their patient "information" leaflets. You'd do better to take questions to people who've taken the meds and use their information, especially as side effects hit at most (bearing in mind the pharma industry's rounding off of figures) 19% of people.

The range of drugs available today is such that I never thought I'd live to see. The worst side effect I've had from my current combination is that the American pitbull who lives over the road doesn't recognise me any more because the ritonavir leaves a coppery smell on my breath.

Edited October 2, 2014 by bearbandit

[Poz1956]

Pitt1988:  There is more to your friend's story than he's telling you.  People don't go from undetectable to treatment failure in a few months without some other factor(s) causing the issue.  Problems with adherence would be my chief suspect.

 

Reinfection seems unlikely.  Exposure to the same guy he caught the bug from would do nothing.  Exposure to other people could only happen if he wasn't taking the ARVs.  Even then, it's usually only one or a few viron that make it past all the bodies defences to set up shop.  His own strain would overwhelm the new invaders.

High blood pressure is really only associated with the protease inhibitor class of drug.  Most first line regimes these days do not include the PI class because of their higher side effect profiles, so I doubt your friend was started on those.  If he caught a multi-drug resistant strain, the doctor might have needed to resort to the PI class, but it seems unlikely.

 

I know I always freak a bit when I have a nose bleed or a cut.  I'm sure as a Neg guy that probably freaked you out too.

 

If it's becoming a chronic problem, your friend should see an Ear, Nose, & Throat specialist.  Vitamin K (and I really do mean vitamin K - NOT the recreational drug ketamine) can help with lessening nose bleeds.

 

I don't mean to cast aspersions on your friend, but is he possibly snorting something?  That might explain the high blood pressure, nose bleeds, and ARV adherence issues.  Did he spill some poppers up his nose?  Just casting around for ideas here.

The question about Truvada and lipodystrophy comes up often in the PrEP Facts Facebook group.  We've got more than then years of experience with Poz guys taking Truvada without that issue.  With the studies we've got about five years with Neg guys on PrEP, and no reports of it.  It's one of those Scary stories the anit-PrEP folks like to spread.

 

 

Bottomhole:  With the horror stories of the past, it's hard not to worry about side effects.  Bearbandit and I have been on the meds for about 25 years.  We were eye witnesses to those bad times.   Some of the early drugs, especially at the massive overdoses they used back then, did cause lipodystrophy.  It's just not something we see on the current generation ARVs.

 

I've talked to many people just starting therapy and they have experienced no side effects, or some mild gut trouble for the first few weeks.  When you mentally and emotionally ready to commit to taking the meds every day, I urge you to start them.  If you need to chat about making the decision, and what to expect, both Steve and I will make ourselves available.  Paraphrasing FDR, you have nothing to fear, but fear itself.   (Yea, I know I'm volunteer you Bear, but I know you would do it without asking.)

[sarutobi]

Here's a list of Truvada's potential side effects. I looked at hundreds of comments written by guys taking PrEP before I decided to get it. Most didn't have any side effects. Those who did weren't sure if it was caused by the drug or something else. I've been taking for a week, and so far I haven't had any side effects. I'm usually prone to experiencing drug side effects. I take Sudafed and I know it's working because I get drowsy. I took Vicodin for a tooth extraction and had crazy nausea. I will never take Morphine again after the way it made me feel. Truvada hasn't caused me as much as a head ache. About the only thing I get is a slight after taste when I take it. 

 

As long as you take Truvada with a decent meal (not a snack), you should be fine.

[bearbandit]

 

If you need to chat about making the decision, and what to expect, both Steve and I will make ourselves available.  Paraphrasing FDR, you have nothing to fear, but fear itself.   (Yea, I know I'm volunteer you Bear, but I know you would do it without asking.)

 

You'd be surprised at the things I'll do without asking , well probably not... Can't deny I'm a whore! Just a re-introduction since the make-over: I've been poz since 1980, have a well-rounded experience of ARVs, and am willing to give honest answers about HIV and ARVs...

[Bottomhole]

Thanks Poz1956 and bearbandit ! I think I'd like to go on meds soon, I was diagnosed 3 weeks ago. And last week went in for my first test (cd4 vl etc) They advised me to get my hepatitis vaccine first, then they would discuss meds.

 

Oh and I believe I was infected the end of May.

Edited October 3, 2014 by Bottomhole

[bearbandit]

To me it makes sense hitting the fucker hard and fast, but I think you're right getting the Hep B vaccination out of the way first, as it's going to screw your numbers because of your body's response to the vaccine.

In my terms (infected before we even knew there was a virus) a few weeks or months aren't going to make much difference. The important thing is that you do eventually get on meds. Feel free to ask questions, either publicly or privately, if you have them. Don't say I told told you but if you google "myHIV" and "UK" you'll end up at THT's frontline website which is supposed to be UK only, though we have members from all over Europe. (The reason I'm not giving the URL is that there's been some major reconstruction work going on there recently and URLs have shifted.) There are forums there where you can explore what's best for you, how anybody else felt on starting medication and so on. I use a different user-name, but the same avatar there, so if you do drop in, be sure to say hello!

[Pitt1988]

Hi poz1956, now i think about it, i believe you are right, in fact my frienship with him has strained overtime because he is a complete jackass; for instance i remember him specifically stating the person that infected him was strickly and only a top, then i personally found out from the guy he is fully vers, and was infected bottoming, my friend is very naive and inane at best; and i do believe lack of adherence may be the cause, he's never been on drugs (that i know of) all i know is that nose bleed was one of the scariest things ive experienced and freaked me out quite a bit, but im sure he is not being upfront about the whole matter, as ive heard of many many poz people living very healthy lives

[seaguy]

has your friend been checked for high blood pressure or is he taking other meds or doing things like lots of poppers or inhaling drugs that might also be causing the nose bleeds.  It is always best to ruled out other factors before jumping to the conclusion that is is his HIV meds.  Would be be open with you if he was say doing lines of cocaine when he hooks up with this guy he met?  That is just a scenario am using not to say your friends a drug user or anything.  But I know from experience you can get nosebleeds doing drugs by snorting them.

 

The meds that caused guys to get fat deposits in areas that they referred to in some cases as buffalo humps were older medications that I don't think are commonly used anymore.  As we get older especially when a guy hits age 30 or so our metabolism slows and on most men the calories that are not getting burned as fast get stored right there in the gut and stomach area.  Could be your friend depending on his age has hit that point in his life and will need to start working at keeping a nice lean waistline.

Edited October 4, 2014 by seaguy

[Poz1956]

One of the dirty little secrets, never talked about in HIV prevention, is that most of this epidemic is caused by Vers guys.  They are most vulnerable when the bottom, and most likely to spread it when they top.  That 1 in 71 chance of catching it while bottoming, magically becomes 1 in 71 chance of passing it on when they top.  The risk even much higher during the acute phase of infection, shortly after they catch the bug.

Not to totally cast aspersions on vers guys.  I am one, and flip fuck nights are great.  At least I think they are -- it's been soooooo long since I had one of those.

 

For the most part PrEP is just personal protection -- A chemical condom and really nothing more.  Pretty important for bottoms, especially for cum dumps.

 

From a public heath perspective, a PrEP campaign targeted at Vers guys might be an idea, since they're driving the epidemic.  PrEPing them would create a choke point for HIV's spread.

But in truth, just getting a larger portion of very sexually active guys following just the PrEP testing schedule of very four months would make the biggest dent in the number of new cases.  From the recently released Kaiser Family Foundation survey, only 19% were tested in the last 6 months, and another 11% between six months and a year.  36% have not been tested in over a year, and 30% have never been tested.  We know self reported testing is higher than actual testing, just like self reported condom use.  A study presented at AIDS 2014 showed that where 50% of gay men reported they tested yearly, records of tests performed at STI (GUM) clinics (and through GPs) calculated that only 20% had actually been tested.