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First Regimen = Sustiva + Combivir + Kaletra? Already?
Oct 24, 2004

I am sure this has been addressed in some other post through some other thread in the past, but it would take forever to try to find those messages. So, here's my question and my issues...

My doc subscribed Sustiva + Combivir + Kaletra this past Friday, though he wasn't there in person to answer my questions so I have held off on starting them until I can talk to him in person.

I've been positive for about two years (maybe a little more) and have had pretty consistent numbers.

My most recent bloodwork was taken 9/20/2004. My CD4 was 450 and my viral load was 3748.

I have not had any infections and am relatively healthy other than this whole HIV thing (I'm about 20 lbs overweight with cholesterol that could be lower -- but who isn't??? haha).

So, am I really crazy for not wanting to start taking meds yet? I have yet to start a treatment regimen and honestly am a bit frightened to do so, but when I see that my bloodwork comes back with pretty stable numbers every three months and they aren't low or high at all (considering the obvious). I don't think I need to do anything yet.

Please let me know if I'm crazy for thinking this way.


Response from Dr. Young

Thank you for your post.

I must say that I'm in disagrement with your doctor's decisions. First off, your CD4 count and viral load are in a range where most American or European doctors would not recommend initiating treatment-- most wouldn't recommend that asymptomatic persons start therapy at least until CD4s were below 350 (never mind the 450 that you're currently at). Moreover, your viral load is quite low (50,000 or so is "average" for persons not on treatment).

In addition, the treatment regimen that your doctor has prescribed is highly unusual for first-line treatment. The combo that you're prescribed is a three-class regimen using members of NRTIs, NNRTIs and PIs. While all of the components of your regimen could be recommended as part of an initial regimen, only two classes of drugs would be usually used. Hence, the combos of Combivir+Sustiva OR Combivir+Kaletra could readily be recommended (and are recommended by the US Department of Health and Human Services and the International AIDS Society).

So, yes, you're not crazy-- I'd be wanting a second opinion before I'd place my vote on treatment with your current doctor. Ask your local AIDS service organisation ( for advice.

Good luck, and let us know how things turn out. BY

Your advice again
Taking A Dose Because You Thought You Missed One

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