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Time to Restart Meds?
Mar 22, 2008

I had been taking Sustiva and Truvada for over two years -- every other day (as prescribed by my doctors) -- with fabulous results... on paper, that is. I couldn't think. My doctor suggested taking me off of Sustiva and finally told me to stop because I was getting to be a lunatic. I realize that it was for my own good. Before I stopped my viral load was undetectable and my CD4 cell count was 265. About a month after I stopped, I had a serious headcold and cough. I switched doctors because the other one was too far away. It's been 3 months since I stopped. My recent vl = 100,000 + copies and my CD4 cell count is 345. I have chills and fatigue, but nothing serious. Would you advise to start meds right away or can I wait for 8 weeks when the results of a genotype will provide resistence information?

Response from Dr. Frascino


You were taking Sustiva and Truvada every other day???? YIKES! That's definitely not a good idea. And you state this regimen was prescribed by your doctor!?!?!?! Where the hell did he get his medical license? EBay? Despite your "fabulous results" and I'm not one to argue with success taking HIV medications every other day is an extremely bad idea that will lead to drug resistance. I'm delighted you are no longer seeing the quack I mean doctor who recommended such a blatantly inappropriate dosing schedule!

Next, why is it taking eight weeks to get the results of a genotype? These results should be available within a week or so. In light of your past medication history and improper dosing schedule, I would not recommend starting a new regimen until the results of the resistance tests are back. If possible, getting both a genotype and a phenotype would be helpful in constructing your next regimen. I would also make sure you are seeing a certified HIV/AIDS specialist for your ongoing care. (I doubt this was the case with your previous "every-other-day is OK"-guy.) You can check the Academy of HIV Medicine's Web site at to find certified HIV specialists in your area. (They have HIV specialists listed by locale.) You should also peruse the wealth of information related to HIV medications and ongoing HIV care available on this Web site and its related links.

Good luck.

Dr. Bob

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