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Truvada only
Oct 23, 2006

Hello Dr. Young:

First off thank you so much for you and all the other doctors who spend their time answering these questions.

I have been hiv+ since 11/98 which turned to aids in 10/06 with complications. I was on Truvada, Zithromax, Bactrim and Kaletra. If I was just to take Truvada which I tolerate pretty ok (except the bathroom stuff) will that be enough? I have resisted for a long time to start any meds as I am not very good at remembering I need to take them, plus I hate taking any pills. I had a wonderful doctor in Virgnia but now I have moved to a very small town in a very small population state where there are no hiv docs let alone ones informed very well in aids Cost is also a major factor as the ADAP program where I live has a very long waiting list (and because last year up till October I worked so my last years income disqualifies me from the drug company free drugs)..Currently because of my aids dementia and other complications I am unable to work and my only income is social security disability (and not that much!) So because of cost I can only at least obtain Truvada at a somewhat reduced cost and am hoping that will be enough for awhile anyway. In October 2005 my cd4 was 32 and viral load over 500k, last test was in June 2006 was cd4 205 and vl 6000, but that was when I was on all 4 meds which I have not been on now for about 2 1/2 months...only Truvada.

I am between a rock and a hard place and at times I feel it is time to throw in the towl and let nature take its course. (I am on Lexapro for depression but it has not been working plus I cannot afford it anyway...geez, keeps getting better!)

Thank you Dr. Young for you help and insight..I will be forever grateful.


Response from Dr. Young

Thank you for your post and questions.

I would do everything that I could to convince you that taking tenfovoir/FTC (Truvada) alone was a bad idea.

Dual nucleoside therapies were tried and failed terribly in the early 1990s. The consequence of this strategy was many HIVers with multidrug resistant virus and progression to AIDS.

It would be best not to take any HIV medications at this juncture, rather than 2.

Your state's ADAP waitlist makes me sick with concern about the risk to loss of access to care and medications that American's face. Let us know which state you live in, perhaps we can inquire about alternatives (you're welcome to drop me a email directly at if you'd like).

Do talk to your AIDS service organization or case manager in your new state. If your current income qualifies, this should be sufficient for patient assistance (most don't require last year's income, as I understand).

So, write us back, let us know how you're doing.

Best of health to you. BY

CD4 150 V.Load Undetectable

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