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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
           
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Avoiding Long term Side Effects
Oct 1, 2004

Thank you for the great work you do on this forum.

I am from South Africa but I am fortunate enough to have access to ARV therapy.

I was diagnosed in April 2004 during seroconversion whilst my antibody test was still negative. At the time my viral load was 750 000 and my CD4 320.

I immediately started ARV therapy with a combination of Stocrin, Zerit and 3TC. My last results were an undetectable Viral Load and a CD4 count of 800.

I have decided to remain on therapy because of the following reasons:

1.I do not want to compromise my immune system.

2.I do not want to lose the benefit of early detection and treatment by allowing the HIV reservoirs to build up.

3.I have no side effects from the ARV therapy.

4.I do not find it difficult to be a 100% adherent.

My questions are:

1. Is there a better combination then the one I am currently on to prevent long term side effects like liver toxicity and lipoatrophy? (I have read about once a day 2 pill regimens with no known long term toxicity.)

2. If so what are they and is it wise to switch seen that I have decided not to discontinue therapy?

Response from Dr. Henry

Great questions and I am delighted to hear that you are on therapy---if only that were true everywhere! The regimen you are on has a great reputation for effectiveness. I have been decreasing my use of D4T out of concern for an relatively increased rate for fat/lipid problems over time (still controversial but most data suggests a greater risk for D4T versus AZT or tenofovir). I often would switch the D4T to AZT if that is an option just to minimize the long term risk. There are no drugs or combinations that do not have some long term side effects (I have been using HIV drugs since 1986 and am learning about AZT even). KH



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