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Starting Treatment
May 30, 2004

I am looking for some input regarding treatment options.

I am 44 y/o, living a healthy and active lifestyle. I have been under physician supervision since August 1999, shortly after my positive diagnosis. Since then, I have not been on any meds as my CD4's and viral load has been well within margins. As of my recent lab results from this April, my CD4 was 358 and my viral load was 153,000 (highest load to date-previous high was 48,000). These results followed an extremely difficult and stressful time in my life. My doctor and I agreed we would review additional lab results in another month and determine what course to take at that time.

At the end of last year I have moved and am under a different physician's care. In conversations with my new physician, I know he differs in opinion from my previous Doctor regarding treatment plans. My previous Doctor would have put me on Trizivir alone. My new doctor originally suggested Sustiva and Combivir. Now, in my most recent office visit, while discussing the results of this lab work, the doctor asked me to think about different regimens that would work within my lifestyle, which may differ from his original thought.

Frankly, now I'm very confused... I do plan on starting medication treatment when the doctor and I agree the time is right, and by the results of my most recent lab tests would indicate that time may be sooner than later. So my question to you is, what type of program is the best? I'm the type of person that can adhere to any regimen as necessary. Although, my lifestyle is active and my job causes me to travel frequently and internationally, I don't foresee difficulty with any regimen. The confusing part is the conflicting information I have received from my HIV physicians about medications.

I truly want to approach this in the best way possible. Your input will be valuable to me.

Thank you.

Response from Dr. Young

Thanks for your question.

I agree with one of your doctors that repeating lab tests can often help in sorting out if one day's tests mean that you should start on treatment. Looks like both agree with me that with your current labs, that starting on treatment would be reasonable, if you're currently able and willing to adhere to a treatment.

I would not, however, suggest that you start on Trizivir alone for treatment, and support your new doctor's suggestion of Combivir and efavirenz (Sustiva, Stocrin). This later regimen shouldn't affect your life- or travel-styles.

Good luck, thanks for reading. BY

+ppd and - chest X-ray.
my cd4's-viral load

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