I have been HIV positive since Oct. 2000. I have never been on meds. My latest Lab work came back of a Cd4 count of 378 and Viral Load of 12629. Over the years I have gone up and down on both counts, however, my last 3 tests have had my cd4s go down about 100. My Dr. thinks its time to start meds. What do you think? The regimen he wants to start me on is 4 Invirase with 1 Norvir and 1 Epzicom per day. Any help with this would be great. Thank you, Bernard

Dear Bernard,

You are getting close. There is no emergency to starting meds now but your counts sound like they are dropping steadily. So, it may be just a matter of time before you drop further - prompting a greater sense of urgency.

When you do start HIV meds I would think twice about the regimen recommended to you. It is not a regimen that is a) considered a preferred regimen in any guidelines, b) not all that easy to take given the pill count, c) carries a 5-10% risk of an abacavir hypersensitivity reaction (less if you are of African descent) and d) may be very unlikely to be what your doctor would take were he to be HIV+.

Why not something simpler and easier? Tenofovir+FTC+efavirenz is a potent regimen that is well tolerated and now comes as two pills before bed. Soon these will be in one single tablet.

DW