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Dear Dr.pierone
Aug 2, 2004

Dear Doc,

I have sevral Qs for you:

with the first time hiv medications if the drugs work well, and also if i don't develop resistance assume i take 98% every day and with good exercise, multi vitamins,positive mind etc... how long the first combination therapy can last? i know this vary from person to person,i just want to know from your clinical experience how long can a hiv + indiviual stay well with the firt medication does medication decrese its efficacy over times? if the first medication lost its efficacy over time and what happed to the second combination will that work as well as the privious one? if not what are the options?

regarding life expectency if i work really hard follow every roles that doctor want me to do can i stay well for 25 years i am asking this because i have a wonderfu wife i want to live for her and also i want to have a child and to see his/her growing up .

my cd4 is 450 and vl is 60000 i know it is not time to start treatment but i want to make a future plane about how far i can live .

and also when you say that with a good treatment hiv + person can live a normal life span ? what does that mean? by the way i am 24 years old healty male.

my last Q is interms of the effectivness of the hiv drugs does the once a day medication as powerful as the twice a day treatment? when i dicide to start treatment with one is the most popular combination with less side effects ?

Daer DR.Pierone i know i am asking alot i hope you can understan how i feel Thank you so much God blees you !

Response from Dr. Pierone

Hello and thanks for posting.

The first combination can and should work for many years. I have many patients that have had an undetectable viral load ever since they initiated therapy in 1997. Not that many are on their first regimen, but we changed not because of failure of the drugs, but because safer and better medications came along. The original medications are still available to them, but probably will never be necessary because of advances in therapy.

Once a day regimens are as effective as twice or three times per day therapy. High level adherence almost always prevents development of viral resistance. This is the best scenario because treatment of individuals with drug-resistant virus is much more challenging.

The lifespan for someone with HIV infection that has access to combination therapy in my opinion will be normal or near normal. Although admittedly, it is difficult to forecast 50 years into the future for someone that is now 24 years old.

Since antiretroviral therapy is advancing at a rapid clip, defer your question about best regimen for the future since the optimal combination today will likely change by the time you need to start. Best of luck!

Dead or Alive ?
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