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Ask the Experts about Opportunistic Infections

 

What now?
Dec 19, 2000

Very short history description:

Diagnosed: 1985

Started treatment 87: AZT until 92 aprox. Revisions every three months, only twice had 450 defenses, all the rest + 500/600.

92: started combined with epivir. Always +600/700

Donīt know exactly when started 3 combined treatments, always +600/700/800

Came out viral charge: always active less 6000 generally, and took Sustiva, Crixivan, Ziagen (did not tolerate) but after six months taking any treatment again viral charge + 5000 - 11000, still defenses +800

Tried videx and Hydrea as last resort before going into protease again (DO NOT WANT TO HAVE LIPODISTROPHY), first results 1900 viral charge, 1160 defenses (29%), second results a week ago 800 cd4 (25%) but 31000 viral charge (it scares me - it is the first time).

My question: what should I do?? Should I take a protease inh. although I really donīt want to, but I also donīt want to deteriorate, or could I try Sustiva f.example again for a while although it did not work as I had 5100 viral charge after six months taking it? until other treatments come out?

Thank you for your attention

Response from Dr. Feinberg

My guess is that you're resistant to 3TC (Epivir), AZT and efavirenz (Sustiva), and probably also ddI (Videx). I think your choices now are: one or more protease inhibitors plus d4T (Zerit), or wait until you have some more options, like tenofovir and T-20. Your current T cells and viral load are not that high and you could wait it out without being in immediate danger.



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