I am HIV+ and need to know more about current medication .Since I was diagnosed with Hiv my treatment was as followed 6- months viramune 2*day combivar 2*day Last 3 months because of cost implication on combivar viramune 2*day videx 100mg 2tablets 2*day zerit 40mg 2*day my questions are a) how should these medicines be taken in relation to meals before or after b)how long will this dual treatment be necesarry or will it only be till my cd 4 has recovered to a certan point was 23 now 243 next 3 monthly test end Nov c)what new medications has been produced , and if my current medication is any good

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Well, I am not sure I understand all of your questions... but here goes.

Zerit and Viramune do not have any restrictions on food - meaning that they are the same whether you take them with or without anything to eat. However, Videx or ddI does have a restriction - and it is clear you need to take it at least 30 minutes before eating, and at least 2 hours after eating. And it needs to be taken with just water. So most will take it first thing when waking up - since you have not had something to eat for several hours - and then you can eat at least 30 minutes later. Similarly you could take the Videx 30 mins before dinner - again assuming it had been a few hours since you had lunch. It does not seem to matter if you take the other pills with the videx or with food - that is your choice.

Now, there is info that shows us that the Videx can be taken instead just once a day - this had become standard here in the US even though the drug was approved for twice daily dosing. So instead of the above, you might talk to your health care provider about taking all four of the Videx tablets once a day (or 2 of the 200 mg wafers if they are available) - say, first thing in the AM. This may be a bit easier. This has also become available as a capsule instead of the wafers - but I don't know if you can get access to that newer formulation.

Now your second question. You ask about dual therapy and the combo you are on is a triple combo - so that is my confusion. But assuming that you are on these three meds - how long to treat? As you report - three drug combos are very successing in controlling HIV - and that allows the CD4 counts to recover. So does that mean you need to take meds each and every day from now on??

Well, this is a big question for us these days. Studies have shown at least so far that when we go from a successful three drug combo such as yours down to just any two of these meds - it has been far less successful at maintaining control of HIV. So taking fewer meds is not yet an option we can recommend. There are studies testing this - but no good info to suggest that this will work well.

So the alternative question is whether you need to stay on these meds - or any meds - every day from now on. And one answer may be yes, that is the best way to go, especially with your history of a very low t4 count initially. Studies however are ongoing investigating both brief interruptions in meds - stopping for a few days and then restarting, as well as longer pauses in meds. There is concern with both of these when on nevirapine as this med complicates the picture -- there are reports about how often HIV can create resistance to nevirapine in those who do stop these meds and some reports showed a high likelihood. So for now, it is likely better to just remain on the meds each day until we have better info to guide us for those on nevirarpine.

However there are studies ongoing and up coming to investigate how well people can do when they take a pause off meds. One for example is called SMART and is just getting underway. It compares two distinct strategies - one is the now standard take meds every day with at most brief pauses, while the other is to take meds to get your CD4 count above 350, then stop the meds, and restart only when the Cd4 count goes back to 250 or lower. This strategy is built on the observation that those who start treatment at about 250 do well - and that living on meds every day from now on may not be the best way to go - so it cycles on and off meds with these cd4 targets. It will be years until we learn the answer to this study - but there are sites just getting underway all across the US and Australia, so some readers may wish to learn more to help answer this question. There is even a web site about the smart-trial to learn more...

Hope that helps.