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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Off beat part 2
Jun 24, 2002

Thanks DR.Henry, I"ve also been considering a monitored sti.As earlier stated my numbers are really good. The thing is sti's are just a waiting game(no one can predict how long each person could safely go)So, I figured since it could take a really long time to lose fat with an sti(longer than sti itself can last)I opted for the faster route of lipo.Now if I decide to do the sti I'm guessing I should wait untill I'm fully recovered from the surgery to reduce any complications associated with a spiking vl or a sudden drop in cd4.I know treatment naive people are told to get other health affairs in order before embarking on antiviral therapy, so does the opposite hold true for individuals on treatment with fully functioning immune systems(take advantage while it's good and strong).

Response from Dr. Henry

There are several studies in the US looking at STIs in patients doing well with chronic HIV infection (ACTG A5102 and the CPCRA SMART study for example). If you aren't interested in a study then a general rule is that the viral load will return to the pre-treatment viral load in most patients. The CD4 tends to fall fastest in those who gained the most CD4 cells on treatment. If you had a low CD4 nadir (i.e. << 200) then I would be very cautious about an STI. KH

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