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Concerned about overmedication, when to start?
Jun 27, 2004

DO YOU THINK THAT COMBIVIR TWICE A DAY AND REYATZ TWICE A DAY ALSO NORVIR ONCE A DAY IS A GOOD COMBINATION OR TO MUCH MY CD4 WAS 516 AND VL WAS 800 I JUST FEEL LIKE IM BEING OVER MEDICATED PLEASE GIVE ME YOUR OPINION

Response from Dr. Pierone

If you started on therapy with a low viral load and high CD4 count, this would be considered a very aggressive approach (and outside of current guidelines). It does not mean it is necessarily the wrong thing to do, but you need to be fully informed of the pros and cons of early aggressive therapy. Do make sure that you have fully discussed the rationale for early treatment with your doctor. We are treating people early in the context of a clinical trial (SMART). This study also has a comparison group of people that defer therapy until CD4 count is below 250.

The treatment guidelines although not definitive, do provide an overview of HIV treatment. We don't always follow them since there are inherent limitations of 'recipe'-based medical decision making.

In terms of the actual regimen, there is really nothing wrong with it. Combivir is one of the most commonly prescribed meds, and Reyataz boosted by Norvir is quite potent and has few side effects. Again though, in your case, one could comfortably say that you don't need to be on treatment at all. Good luck and let us know what you decide to do.



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