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Dec 25, 2005

I tested positive last october. I never had any pain. Then my cd4 came 212 and viral load 93,232. My doctor put me on medication right away. I started 2 weeks ago with Duovir 200mg(Lamivudine and Zidovudine) twice a day and Nevirapina 200 mg once a day. Yesterday I started Nevirapina twice a day. How bad this medication are for my liver? And my girlfriend tested negative. We have been together for 3 years with unprotected sex. How come she has not get it? Do I stand a chance to live longer?

Response from Dr. Young

Thank you for your post.

You're taking one of the more popular drug regimens in the developing world-- one that is usually very well tolerated and a simple 2 pills twice-daily regimen. The side effect profile is very well known and characterized; the zidovudine (AZT) can cause nausea and headaches and in a minority of patients, anemia can result. Lamivudine (3TC) is usually very well tolerated, without significant side effects.

Nevirapine can cause rash in some patients and in a very small number of patients can cause liver toxicity (especially among those patients who start treatment with higher CD4 cell counts). With your CD4 count of ~200, you're not at any significant risk; most of the risk occurs in the first 2 or 3 months of treatment.

I'm happy to hear that your GF is HIV negative--call it good luck, perhaps the amount of virus in your semen has been low in the past.

In either event, yes, you do have a very good chance to live together for a long, long time. Among my patients who are able to be adherent to their first-line HIV treatments, I expect normal, or near-normal life expectancy.

Do your best to stay as close to 100% on the adherence, stay in communication with your doctor about any problems or side effects that you're experiencing and I'd expect you to live a very long time, without symptoms of HIV.

Good luck, let us know how you're doing from time to time. BY

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