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Mar 6, 2003

Hi doctor Young, thank you for answering my last question. As you suggested for me to take another test I did, my test results were almost the same. Here is the story, my first blood work was kind of bad, T-cells were 251 and viral load was 11,700 copies, my doctor restest me and the results were t-cells 409 and viral load 9 thousand copies. After u recommend me to retest, I did and now my test-results were 471 t-cells and 11,300 copies of viral load. Okay here is my question, my doctor suggested me to start treatment because I have signs of anal warts and she said that by starting treatment I can suppress the warts. I almost sure that I will not mind starting treatment but one concerned is lipodystrophy, do you think if I start treatment early I will have higher chances or less likely to develop lipo. Do you think that trivizir is a good first treatment to start. I hope u answer my question. Thank you in advance.

Response from Dr. Young

Thanks for the follow up.

You raise a couple of very important issues.

The first is that the risk of lipodystrophy actually appears to go up if one waits longer to start therapy, this would argue against delaying too long to initiate therapy, with lower CD4 cell counts.

The components of Trizivir (ZDV,3TC,ABC) have not been shown to cause excess risk of developing lipodystrophy in any studies that I'm aware of, though it would be important to note that these are very commonly prescribed medications.

For persons like yourself, with "symptomatic" HIV disease, many would suggest treatment, though I wonder if agressive treatment for anorectal warts might aleviate your situation without the need to use antiretroviral medications.

Either way, Trizivir would appear to be a very reasonable regimen for a person with a viral load around 10,000. Monitoring for adherence, side effects and viral response will be important, as it is for any initial drug regimen. -BY

CD4 percentage

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