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thanks for replying

Jan 7, 2006

thanks for replying because your kind gesture can save someones life. i just wanna ask you one thing not bother you that much my friend whose cd4 is 165 and vl is 2.5million .he is also a diabetic .i want to ask what drugs should i start and how should i then treat his diabetes whicg haart therapy is best for him.will he have to come on insulin.please let me know the viral drugs which i should try on him thanks. DR SHEHARYAR

Response from Dr. Young

Thanks for your follow up and kind words.

Your friend should certainly be considering starting HIV medications with a CD4 count in the AIDS range and a very high viral load.

He should be starting on the most potent, and well tolerated three drug regimen possible. By current conventions, this would mean a regimen of 2 nucleoside drugs with either a non-nuke (efavirenz/Sustiva) or a ritonavir-boosted protease inhibitor (lopinavir/Kaletra; fosamprenavir/Lexiva or atazanavir/Reyataz are popular ones in the states).

The possibility of complicating his diabetes is notable-- to this extent, some of the protease inhibitors can exacerbate sugar control, but generally not to a significant degree. The other issue to note is the possiblity that your friend either has, or is a risk of developing kidney disease (because of diabetes)- tenofovir (Viread or Truvada), if prescribed, should be monitored closely.

It's important, as you suggest, to try to tailor medications to a patient's particular set of needs. Because of this, please make sure that your friend gets good medical advice.

Good luck to you and your friend. BY

Afraid of being resistant to all Meds
Vaccine Effect on CD4

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