Dear Dr:

I'm having triple bypass surgery in a week or two, and I'm not sure what to do about my Trizivir. The surgery itself and the recovery time will make it almost impossible to take the Trizivir like clockwork as I accustomed. What would you suggest? I had thought about stopping the Trizivir until I'm out of the hospital, but don't know. My current VL is UD and my CD4's are at 560. I'm afraid that if I don't completely stop, then the missed and/or late doses will cause more harm than good. Thanks.

In general, I would think that you should be able to stick to a once a day regimen with perhaps one missed dose during your surgery. I would clearly discuss your desire not to miss doses with your surgeon and your HIV doctor to come up with the best option for you. I do not think it should be necessary to stop your medications though - you could even have your medications adjusted to a liquid formulation which can be passed down a tube into your stomach if this is necessary. The exact hour of the day is less critical - just try to get as close as possible to a regular timing each day and not to miss more than one dose.