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What would you recommend?
Jul 28, 2003

Mr. Vergel,

Stay strong trooper. We are all pulling for you. Keep up the great work and will god always continue to bless you and keep you well in your effort. If you were needing to start therapy today, how would you go about it? Would you dedicate yourself to 3 meds and try to minimize side effects or would you go on and off in months?

Jim Horton in Tenn.

Response from Mr. Vergel

Thanks Jim for the encouraging words. If I was to start therapy today, I would follow the guideline recommendations of waiting til my T cells were close to 350 or VL over 50,000. I would get a genotype test first to make sure I did not get a virus with preexisting multi drug resistance. Then I would start a combination that would give me the best chance for long term viral suppression while managing side effects the best way. I would try to leave the "D" drugs for later (DDI, D4T, DDC, and even AZT) because of their known effects on the mitochondria and fat cells. I would probably start with Kaletra plus Viread(or Viramune) plus Epivir (or Emtriva). I would keep an eye on my lipids, exercise, and eat balanced meals. And, of course, I would do all the things I am doing now to keep my body in shape and best quality of life.

Nelson



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