DEAR SIR MY FATHER IS TAKING ZIDOLAM-N(ZIDOVYDINE 300mG, LAMIVUDINE 150mg, NEVIRAPINE 200mg) FROM LAST 5 YEARS. IN 2007 CD4 COUNT WAS 111 AND AFTER MEDICATION IN 2011 IT INCREASED TO 439 BUT AFTER THAT IT STARTED DECREASING NOW IT IS 211 AND IT IS DECREASING CONTINOUSLY. AND FROM LAST 2 MONTHS HE IS IN HOSPITAL BECAUSE OF ASHTMA PROBLEM DOCTOR HAVE GIVEN STEROID BUT PROBLEM IS NOT GOING AND HE HAS DEVELOPED FUNGAL INFECTION IN CHEST ALSO. BREATHING DIFFICULTY IS NOT REDUCING. PLEASE SUGGEST WHAT TO DO NOW.

You don't indicate whether and HIV viral load test was obtained or even available to be obtained. It may be that the current regimen is no longer working and that the virus has developed resistance to one or all of the medications in the HIV regimen. If viral load and resistance testing is available, those tests should be obtained to determine what to do next. If they are not available, then a new regimen should be started with HIV medications that might be available and that are likely not to be cross-resistant to the three medications he is on.