I was infected 2 and a half years ago and my last cd4 count is 345 and I`ve been offered to start treatment with either 1) videx/epivir/stocrin or 2)combivir/stocrin. I don`t have data about my viral load. I`d like to start with the first combo since it is once a day regimen but it seems (on this site) the second combination is preferable (combivir and stocrin). Can the first combo be as good as the second one, regarding the possibility to achieve full suppression of the virus and side effects? Which of these two would you recomend? Please help me, it would be easier to start with your opinion. Can you please give me link to official US guide about which meds to start with and which one are alternative options. Is there any Europian guides or it depends on the country? Thank you very much for all your work here!!!

I agree with your docs that this is a good time to start treatment. Stocrin (efavirenz) is a good choice for most people (it can cause rash or some dizziness, disturbing dreams and depression...if these are potential probelms for you that should be discussed with your doctor).

Both Videx/epivir and combivir are considered second line therapies by current practice and US and European Guidelines (http://aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL.pdf; or the European Guidelines: http://www.europeanaidsclinicalsociety.org/guidelinespdf/1_Treatment_of_HIV_Infected_Adults.pdf). Combinations with Truvada (tenofovir/emtricitabine) or Epzicom (abacavir/lamivudine- after HLA B5701 screening) would be better choices--more because of side effect possibilities than for strength. Videx/epivir may be more likely to cause painful neuropathy or pancreatitis (inflammation of the pancreas which sits behind the stomach and can cause pain/vomiting and can be severe in some cases) as well as changes in body fat. Combivir can cause anemia and may cause body fat changes. There are more studies that have used combivir and it was a mainstay of treatment for many years. So if you had no other options and did not have anemia combivir might be the better choice (also Videx and Epivir share a high degree of cross resistance-so it may be easier for your virus to become resistant on that combo if you missed doses).

Good luck.

Joe