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Sustiva/Combivir Expectations
Dec 19, 2006

Hello Doctor,

I'm a 50 year-old male, and I was diagnosed in 2005; had PCP pneumonia. A near-death experience, with a month-&-a-half

hospitalization. The doctors said I've probably been positive for quite a long time.

It's taken nearly a year of recovery since my hospitalization. I had to re-learn how to breathe, walk, use my hands, get stronger, climb stairs, gain weight {I went from a former 215 lb. male, 6'2" tall, to 175 lbs., and SO weak; & since, have come back up to 235 lbs., and close to my former physical "strength"!} ...and get my head straight with all this).

Doctors have prescribed Sustiva/Combivir, and it seems I take to it well. At the start, I was at a CD4 count of only 40, with a viral load of 260,000. Since

I been on this HAART therapy, my CD4 has passed 200 (I'm due for my latest tests, after 6 months, soon.), and my viral load has become undetectable. I adhere to my pharmacological regime

religiously, an hour or two off only very rarely. Three pills a day isn't that hard to comply with, in order to live. I get an occasional bout of nausea, but, I can take it (-similar to my younger, hard-drinking days ).

I've no hypertension or diabetic or lipid issues. Hepatic & renal functions normal. I do have a nasty neuropathy in my feet, though. I've had that for about 2.5 years. I stub my toes a lot. I no longer require oxygen to function normally.

My lung-doctor's given me a clean bill of "pneumo" health.

Now, that you've got a some facts, It's time to ask "The Questions"...

How long can I expect this to work?

How many stages of drug therapy can I expect?

How long can I eventually live?

What is the state of current suvival statistics, ca.2006, given my circumstances?

Tough questions, I know, but what is a decent answer to each?

Response from Dr. Pierone

Hello, and thanks for posting.

You can expect antiretroviral therapy to work for decades to come as long as you adhere to medications. You can expect at several stages of drug therapy over the coming decades based on advances in drug development and the availability of safer, less toxic medications. The first stage should be right away consider getting off the AZT and switching to Viread in order to get rid of the occasional bout of nausea and lessen your chances of worsening neuropathy. Finally, you can live a normal or near-normal lifespan based on extrapolation from the last 10 years (1996 to 2006) of HAART. Let us know how things go and best of luck!



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