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Can I go back again?

Aug 31, 2004

Dear Dr. Lee: I was diagnosed HIV+ eight years ago after a bout with shingles. I was immediately placed on a regimen of Crixivan/3TC/Zerit. I was very faithful to it despite the eating restrictions and having to get up and go to bed at the same time every day. I noticed some facial wasting and a thickening chest (not waist as I usually read about). I became increasingly concerned. I was also burning out from the schedule and needed a break. My viral load was always less than 50 and my CD4 was always between 1000 and 1200. But I had heard of simpler regimens and decided to try one after a "drug holiday" of 5 months. My CD4 is now 556 and my viral load reached 124,000. I have been placed on a combination of Kaletra/Combivir for about 2 weeks. I am experiencing a flush feeling in my face and fatigue. It has got me worried that I never should have taken a holiday and switched since aside from the body changes, I always felt fine. My question is this: since my first line treatment worked so well, is it possible to return to it now that I've "tasted" Kaletra? Or should I carry on and find something new? (My doctor said the Combivir may have negative effects). I really don't think I can stand to feel like this for the rest of my life. Any suggestions. I'd appreciate it.

Response from Dr. Lee

It sounds as though you have many options. Yes, you could go back to the Crix combo or you could talk to your doc about other possible combinations. In fact, it does not sound like there is any combination that you really should not try. Regimens have different pluses and minuses including side effects (including fatigue, fat changes, etc.). It is also possible that the side effects you are experiencing may resolve with a bit more time. Review your options with your doctor.

Be well.

viramune + prednisone
Switch or leave well enough alone?

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