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Ask the Experts about Choosing Your Meds
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Continue to wait or waited already too long?
Jul 2, 2005

Hello from Germany! I was diagnosed in Sept. 1989 with HIV and have done little or nothing about it other than having tried to live a somewhat healthy live ( albeit w/occasional drink and cigarette). The past week a small reddish mole was removed from the back of my hand the dermatologist diagnosed it in the lab as KS. Should I accept this as a single episode and continue to wait starting with treatment at a later point(which I would prefer) or is really time to accept the inevitable and start treating. If the latter is your recommendation pls,pls direct me to the preferred choice of treatment at present - there are so many conflicting strategies and I would obviously like to get directed to the one with the least toxitity and side effects especially that horrible LIPO. For your additional info 10 years ago I had Hepatitis A and I now have noticed a white fungus on my tongue ( possibly oral hairy so and so - related to the KS Herpes if I am correct). Other than that I feel absolutly fine!! I applaude this site and wish you all the very best and look forward to your reply with great thanks!!

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   Response from Dr. Young

Guten tag.

Thank you for your post and nice comments.

If you have a biopsy-proven Kaposi's lesion, then there's no debate: you now have an AIDS-defining illness; irrespective of your current CD4 cell count. You definitely should consider starting on antiretroviral medications in the very near-term future.

Preferred treatments include a variety of two nucleosides (like Truvada or Epzicom-- called Kivexa in Europe; or the older standby Combivir). These would be used in combination with either efavirenz (Sustiva, Stocrin) or a boosted PI like Kaletra. Recently, here in the US, we have started a very large number of patients on the newer PIs, atazanavir and fosamprenavir. The later has gained recent popularity because of the lack of dietary restriction and no need to avoid proton-pump antacids.

Talk to your healthcare provider about your best options and feel free to write back to our site.

With best wishes for a long and healthy future, BY



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