Dear Doctor:

I am a 25 year old male who has recently (within the past 5 weeks) been infected with HIV. I've read various articles that all basically are inconclusive as to the benefits of early treatment during the acute stage of initial infection. I live in the U.S. and lack insurance, therefore I'm considering participating in a clinical trial. The one which seems most appealling to me is one in which the study group is randomly divided into two groups: Group 1 gets Cyclosporine A for four weeks, in addition to a 48 week regimine of Trizivir and Kaletra; Group 2 gets only the Trizivir and Kaletra. My question can be divided into two parts: "Is Trizivir and Kaletra a good initial therapy? " and "What is your opinion on the potential of Cyclosporine A to reduce potential damage to the immune system/cd4 cells?

This is certainly an important study - a previous trial of cyclosporine plus HAART in primary HIV infection showed very promising results. The use of Trizivir and Kaletra is a very aggressive regimen and not one that would likely be used outside the context of a experimental protocol. My opinion is that immune modulators like Cyclosporine may ultimately play a role in HIV therapy and controlled studies of this strategy are long overdue.