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How Long Can I Take The Same Meds?
Jan 13, 2009

Hi Dr Young!

Greetings from sunny Australia and a fantastic 2009 to you! Many MANY thanks for all your hard work - it certainly is appreciated!

I have been on Sustiva and Truvada (our 2-tablet version of Atripla here in Australia as you know) for about 7 months now.

When I started, my CD4 was 330 and 22% and my VL was 335,000 (log 5.53).

After a check at 6 months my results were as follows:

Viral load remains undetectable, CD4 now up to 670 (28%). Biochemistry is normal with lipids still low normal - cholesterol 4.4 and triglycerides 1.2.

My specialist is very happy with these results and says I am doing well.

I have only ever missed one dose due to the airlines losing my luggage (lesson learned!) but I believe this wouldn't have any adverse effect missing this one dose.

Trouble is, it all seems *TOO* easy! HIV? Not a problem! I can control it! Going to die? No! I keep reading I have a normal life expectancy now.

I have no side-effects whatsoever. For me, taking these 2 pills every night is like taking vitamin pills. I hardly even think of being HIV positive these days.

As these meds seem to be working, and I have no side effects, just how long can I keep taking them? 2 years? 5 years? 10 years? More?

I'm only 36, so I guess I have (hopefully) another 40 years of HIV medications ahead of me if all goes well.

Is there any reason the meds would stop working or I would become resistant or something?

This regimen seems to be working just fine for me, so is there *ANY* reason it would fail in the future??

My life just seems so "normal" now. Can I really keep going like this for years with no complications? Like I said, it just seems too easy, and that's got me worried.

Am I being silly?

Finally, I don't drink a lot of alcohol and I don't take recreational drugs. I do smoke however. I really want to quit. I have tried cold turkey, patches etc but nothing seems to work.

I have heard about a drug called CHAMPIX. Would taking this have any bad reaction to my HIV meds or psychological status?

Many thanks again, Dr Ben, and let me buy you a cold Aussie beer next time you come back here! You're always welcome.

Aussie Guy.

Response from Dr. Young

Dear AG, thanks for your post from 'Oz and for sharing your very positive experiences with medications.

You're not being silly at all. Your's is not an uncommon experience-- medications can be very well tolerated and convenient to take. So long as you continue to have access to- and take your medications, I'd see no reason why they won't work for many, many years to come. The possible caveat is superinfection with a drug resistant virus (which is why I continue to recommend safe sex for my patients who are taking HIV medications).

For my patients like you who seem to have conquered the medications fear, loathing and side effect thing, we're now focusing a lot of attention on other preventive medicine strategies. To this extent, the next big health risk for many (like you) is smoking-related disease. We've had very good luck using Champix (Chantix, here in the US) to help with tobacco cessation.

I'll let you know when good fortune takes me to your lovely part of the world- until then, here's a toast to your good health.

BY



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