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Not sure about starting treatment
Jan 1, 2008

I was diagnosed in Oct. 2006. I started with a viral load of 19,000 and cd4 of 519. Currently my viral load is 39,000 and my cd4 is 338. My physician says it's best to start treatment. I want to be healthy and live for as long as possible, but am fearfull of the meds and particularly information from this site, stating that there is no presented study regarding the combination I am to start. I am resistant to non-nukes. I have been prescribed Truvada, Reyataz and Norvir. Is this sensible as a first-line regimen and does it leave plenty of opportunity for sequencing? Aren't PI's supposed to be saved for last line use? Thanks to all for the advice I have already received and hope to receive now.

Response from Dr. Young

Thanks for your post.

First off, before concluding that you need to start medications, it's probably worthwhile repeating the lab tests. You have only a single CD4 count that indicates the need to start.

The notion that PIs should be saved for last-line is antiquated and certainly inappropriate for persons like you who have acquired NNRTI (non-nuke) resistant virus.

The regimen of Truvada + Norvir + Reyataz is less well studied than other boosted PI regimens, but nonetheless recommended by US treatment guidelines. Boosted PI regimens like this tend to preserve options in the unlikely event that treatment failure occurs- it's quite unlikely to see multidrug resistance emerge after failure (in contrast to first-line NNRTI regimens).

Best of health to you, BY

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