My father was diagnosed with HIV and prostate cancer over a year ago. He started chemo two weeks ago, his count CD4 was above 200. He got sick from chemo,got admitted with bacteremia and now his CD4 dropped to 109! He is weak and bedridden. He had a recent appointment and now there's lesions--about four of them inside his mouth. He didn't start any HIV medication yet and will soon. What drugs do you suggest for a 76 year old man with prostate and aids. He's been talking about dying for the past few weeks.

Please, I need your advice other than his doctor's. She is away on vacation. He goes to the Shattuck in Jamaica Plain, in Massachusetts.

Please Help

Starting HIV therapy now makes sense if your father's doctors expect him to have a reasonable chance of surviving his cancer in the near term.

Assuming they do, I would be sure that your father's HIV doctor and oncologist talk to one another about his HIV medications to avoid overlapping side effects such as anemia, nausea, liver toxicity etc.

There are many combinations that are probably available to your father. His age is less of a concern regarding treatment choice than his other medications and any other medical conditions.

For certain, though, your father should be on medication to prevent PCP, a serious pneumonia that develops in persons with poor immune systems.

DW