Hi. I am a caucasian gay male, 40 yrs old, living in south africa, recently diagosed with early in-situ rectal carcinoma and HIV {diagnosed concurrently). viral load 32 000, CD4 126. it appears that we have a window of opportunity to commence with Arv TREATMENT before any further action (chemo/and or radiation) may be required for CA treatment. i am interested to know what arv treatment may be advisable in view of a forthcoming need to treat the rectal CA with chemo and/or radiation, bearing in mind tht in this country we may not yet have access to the newsest/latest regimenns availble in the first world. sincere thanks for a phenomenal, informaive, resourceful and compassionate source of information. david

David,

Thanks for your post and nice words.

Irrespective of the rectal carcinoma (but especially in light of it), I would be recommending starting antiretroviral medications- with a CD4 count of 126, you have quite severe immunosuppression and are at risk of further complications.

While the so-called "best" medications may not be available yet in RSA, what is available is life saving. Assuming that things go well from a virological standpoint (and adherence), you can plan for a future switch to a "better" regimen when they become available.

For the most part, treatment of the rectal cancer can happen without interruption of the HIV medications.

Best of health to you, BY