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Just curious, since I am wondering about STIs?
Nov 19, 2003

Dr. Bob,

I am very fatigued of having to take pills everyday. I am sure you understand. I am wonder about a couple of things about would appreciate your input. Dr. Bob is it feasible that one can take these drugs for like the next forty years of their lives everyday without interruption. It just seems like that liver failure, pancreatis, or kidneys failure will kill you first.

What I am wondering is what you do you think? How long have you actually been on therapy, did you start immediately when Pi came out or did you wait till your cd4 came down, and have you ever went on an Sti?

And does Sti research today look any promising?

Thank you very much. Please stay well. You are such an inspiration!

With love,

Humard

Response from Dr. Frascino

Hello Humard,

Yes, I certainly understand "treatment failure" resulting form having to adhere to complex HAART regimens day after day, dealing not only with annoying side effects, but also with the possibility of severe drug toxicities. Based on the progress that's been made over the past two decades and the new drugs in the development pipeline, I'm quite confident we won't be taking our current medications 40 years (or even five years) from now. Considerable research is now underway to develop drugs that are safer and more convenient to take. (Fewer pills, fewer doses, fewer side effects, etc.)

I started HAART in July 1996 after the Vancouver World AIDS Conference. My T-cells were falling and my viral load was rising at the time. I have never taken an STI. Immunologically, the concept did not make a lot of sense to me. I have always cautioned against STI's, except in the context of research protocols. Multiple studies have now been completed, and overall, the news is not encouraging. STI's are a risky business with a considerable downside risk, especially for those of us who are chronically infected. I continue to advise against them in most situations.

Work closely with your HIV/AIDS specialist, Humard. Talk to him/her about your concerns, and see if perhaps there are options to simplify your regimen.

Let's both stay well and get through this together. Forty years from now, we'll look back and reminisce about the "bad ol' days," OK?

Dr. Bob


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