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Change in Meds / Travel Concerns

Nov 13, 2000

My husband found out he was positive in 1999. He had a cd4 of 12 and vl in excess of 750,000, and was in the hospital for PCP. He started treatment Aug 1999, and cd4 has hung around the 289-329 mark with vl less than 400. His original treatment was a 5 drug combo, with Combivir, Viracept, Ziagen, and Sustiva. Since he has been at or above 300 for his last 2 blood draws, his doc took him off of the Viracept, saying that he would like to save that one for later. Do you agree? This took him from 17 pills a day down to 7, which he really likes. But I, being the worry-wart of the house, am concerned. Your thoughts?

Also, I would like to surprise him for his birthday with a cruise to the Caribbean. I have read the CDC site on travel, but with his numbers, is there any reason I should consider domestic travel instead? Thanks, from the worried wife.

Response from Dr. Stryker

He should be fine without the Viracept. By any standard, his initial five drug regimen was aggressive, perhaps overly so. It is not surprising that his CD4 has risen and viral load is undetectable on such a potent regimen; I think the concept of trying to save one of the three drug categories (ie, protease inhibitors, like Viracept) in reserve is a good one.

Travel on a cruise like the one you have in mind should also be fine. He should check with his doc about any suggested vaccinations, such as Hepatitis A vaccine. Have a great trip! RAS

Rick Stryker, M.D., M.P.H.

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