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intensifying
Apr 27, 2003

nelson,I recently heard you lecture in Ft Lauderdale and was thouroughly impressed with your knowledge.I wanted to ask your advice but didnt feel it matched you topic.I have been HIV+ for 4 years.My first treatment was combivir and crixivan.After two years I decided to drop the Crixivan and have been taking trizivir for two years very successfully.Have been undetectable and t-cells 400-500 for the last 4 years.My doctor recently informed me about a recent study that has shown that trizivir may not be as effective as initially thought and has suggested that I intensify now as not to risk resistance.She has suggested either adding viread or sustiva.I am concerned about the cns side effects of sustiva and the acute renal failure effects of viread.Also sustiva is kind of the gold standard and viread is a new drug.After twenty years of fighting this disease I can see the amount of knowledge you have and I would respect your opinion.Could you please give me your insight into these two drug options and possibly whay you would choose in my place.Also I am very interested in a list of supplements that I should be taking on a daily basis besides my meds. thankyou again and I really enjoyed your lecture.it gave me great hope. I also oredered your book yesterday at Borders. god bless

Response from Mr. Vergel

Viread and Sustiva a potent once a day drugs. The incidence of CNS effects in Sustiva is high but some people seem to get over them OK (those with pre-existing depression or sleep disorders seem to fair more poorly with side effects). The kidney side effects of Viread have been in a very small proportion of patients. Sustiva can change some of your metabolic parameters like lipids and insulin resistance. So far , no real increases in lipids or insulin resistance have been observed for Viread. Talk to your doctor about the two. I would probably intensify with Viread. As far as supplememts, I would take Calcium/Vit D for bone health, Selenium at 200 mcg/d, a good B-100 complex once a day and Omega 3 oils and Carnitine if you have high triglycerides and LDL cholesterol. Thanks for coming to my lecture! By the way, we run out of books and only sell the ebook version at www.medibolics.com. It will take 2 months to get the 3rd edition out.



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