Dr Dave, noticed your response to "being on meds & side effects etc recentlt. I have more specific questions. I seroconverted 18 months ago and my doc & I decided to start treatment similiar to the SMART study secondary to my acute viral reaction & that I was "probably within that 12 week window. I have been on Sustiva , Epivir, & Viagen w/o any compliactions that I know of . I already have high chol(prior and am on meds & bipolar & on meds) ( what a wack job huh)Anyhow I have a tremendous amount of stress in my life right now and have needs at least BID Valtrex to keep from herpes outbreaks. My GFR done by radioactive quaniative(sp) right prior to the the infection and was 76. I want and need to stay on the meds for now. Does any one of these meds appear to do more kidney damage than another? I'm so trying to increase water intake & my BP is always excellent. Sorry for such a long question. By the way I'm 50 and would be thrilled with kidneys that kasted 25 years at this oint. You guys are all great.

Your meds (efavirenz, 3TC and abacavir) are not considered to be harmful to the kidneys. Valacyclovir can percipitate in the urine and cause problems so I would try to find the lowest dose you need. HIV itself can probably damage kidneys and treatment with effective therapy may actually improve your renal function.

I would monitor renal function on therapy even with a calculation of your creatinine clearance done easily by your doc. Any sign of trouble should lead to a nephrology appointment for a closer look.

DW