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First year of HART what next?

Nov 6, 2006

I tested positive a year ago, right at the time of my sero-conversion in October 2005. I started in the "Options" Study here in San Francisco taking Kaletra and Trizivir. Along with that for the first month as part of the studies I took a dose of cyclosporine. I have now been on Meds for a year and am looking for new options to discuss with my Dr. I continue to experience GI side effects even with the change to the newer version of Kaletra. My most recent labs show: Viral load undetectable (from all time high of >500,000), CD4 1316 (at seroconversion it was 774) , CD8 980. I don't know if I should look at stopping meds completely for the time being, or what other med options I have to eliminate the GI side effects. I have heard Sustiva or Truvada are working for friends and my doctor also mentioned some meds can be harmful to my liver with higher CD4 counts.

Response from Dr. Pierone

Hello, you have quite a few options to choose from at this point.

One is to simply stop medications and see how things go. This might allow you to see if the original regimen with HAART and cyclosporine favorably influenced the viral dynamics and perhaps resulted in a lower viral "set point". Of course, since one does not know what would have happened if you did not take therapy, any conclusions would be speculative.

If you are interested in staying on HAART, then switching to a less toxic regimen makes a lot of sense. Probably the simplest approach would be to change to once daily Atripla (Viread+Emtriva+Sustiva).

Best of luck to you and let us know what you ultimately decide to do. Thanks for posting!

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