why sooo many pills
May 20, 2005
you have said many times you take up to 20 pills a day. I thought most people take a three pill regime.How come so many pills.
Also I have read most advise not starting treatment until cell count is around 350.
Am I correct that you started treatment right away? What is your opinion on this subject as to when to start?
may god be with you
Response from Dr. Frascino
Actually, I take 30 pills a day, but not all are anti-HIV medications. In fact, quite a few are medications used to treat the complications of my HIV drugs. Yes, it is true that someone who begins HIV treatment today may need only a few pills per day. This is due to improvements in HIV medications fixed-dose combination pills, extended release formulations, etc. However, for many folks who have been on treatment for years, many of these medications may no longer be viable options, due to development of drug resistance, side effects or toxicities. I, for instance, do not have many desirable options for a potent regimen available to me. And so for now I have to take fistfuls of pills. Of course, if I don't count Viagra, I suppose that number would drop considerably.
There are some promising new medications in the drug pipeline. Let's hope they arrive soon and are both effective and well tolerated!
The ideal time to begin HIV treatment remains unknown. The guidelines have changed as we've learned more about the medications, the risk of side effects/toxicities related to their long-term use and the natural history of HIV disease. From what we know today, a CD4 cell count of 300-350 should, in my opinion, trigger a serious discussion about starting HAART (Highly Active Anti-Retroviral Therapy). Working closely with a competent and compassionate HIV specialist is essential to understanding the risk-benefit ratio of the various treatment options as well as when to start.
When I was occupationally exposed to the virus in Jan 1991, I took AZT as post-exposure prophylaxis for one month. Unfortunately, despite this therapy, I still seroconverted to HIV positive. I did not restart antiretroviral therapy until 1995 when my CD4 count had fallen to the mid 300 range.
Hope that helps.
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