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A Different Kind of Valley of the Dolls?

pill popping pollyanna

Alan Andrews-Katz takes almost as many pills as the number of years the long-term survivor has been HIV-positive. The 51-year-old from Washington state takes 30-plus pills a day but still manages to retain what his husband of 16 years, Eric, calls a “Pollyanna attitude towards life.”

More than three decades ago, Andrews-Katz was told he only had a few weeks to live. He’d been diagnosed with AIDS and was suffering from cytomegalovirus, an inflammation of eye. 

“I decided since I was going to die anyway, I would allow them to try a new drug on the CMV with the hopes that what they learned would help someone else in the future,” he recalled in 2016. The drug may have helped saved his life, but “that medication killed my kidneys.”

Andrews-Katz, who was one of Plus magazine’s Most Amazing HIV-Positive People of 2016, tells us more about his experience switching HIV medications.

That early treatment destroyed your kidneys; has that impacted what kinds of meds you’ve been able to take? Having end stage renal disease greatly limits the medications I can take. A majority of HIV meds are cleared by the kidneys. Since my kidneys no longer function, levels in the body can become toxic fairly quickly. Unfortunately, I can take none of the combination products such as Combivir that are currently available. This is frustrating when trying to lower the sheer number of pills I take in a week.

How many times have you switched medications? The first [antiretroviral] medication I was on was AZT, 26 years ago. Since that time, I’ve been on three other regimens. The first switch was due to more effective medications being developed than AZT. (Thankfully. That medication was difficult to take for me due to the nausea and vomiting it triggered!)

Have you developed resistance to any HIV medications? I have developed a resistance to one of the medications in the second regimen (after AZT) that I was on. Luckily, I have not developed resistance to other medications.

Can you describe what happened when you developed resistance? How did you realize the meds were no longer working? Increased viral load was the main indicator. I had maintained an undetectable viral load for years, however we saw a drastic increase in the numbers between testing periods. Other than what seemed to be an increase in colds, the blood work was the only way I could tell.

What are you on now? Currently my regimen includes Prezista, Norvir, Intelence, and Viread. I’ve been on my current regimen for two years, with my viral load currently undetectable.

Do you worry about developing new drug resistances? I greatly fear developing resistance to any part of my current regimen. As stated before, I have very few options left to me due to [kidney failure]. Unless any new drugs are on the horizon, I have only a few options I can use.

Is there anything you’d like others to know about dealing with drug resistance? Be diligent with taking your medications. Starting and stopping them increases the risk of developing a resistance. If it works for you, better to keep as many options open for treatment for as long as possible.
Plus, whenever I’ve switched regimens, there’s been a whole new set of side effects to deal with. It can also take some time to get used to a new dosing schedule.

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