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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
          
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Too early to have begun treatment?
Jan 26, 2005

I tested HIV+ in December of 2003 following a severe conversion illness that was complicated by a syphilis co-infection. When first tested, my CD4 count was 256 and viral load was 298,000. By February 2004, my CD4 count had recovered to 586 and viral load had decreased to 112,000. However, because my doctor initially missed the syphilis co-infection, I was experiencing symptoms that we thought were attributable to the HIV infection (peripheral neuropathy, continued night sweats, sore throat, etc.) and decided to start medication. At my doctor's suggestion, I started anti-retrovirals in February 2004 to "knock down" my viral load. I started on Combivir/Norvir/Reyataz then later switched (due to heart related side effects from Reyataz) to Truvada/Norvir/Lexiva. I have had undetectable viral load since September and CD4 count of 550. I am 40 yrs old and tolerating the meds with very few side effects and have not had a problem with adherence to the once a day regimen. But my question is whether I should continue on the meds? I am worried that I rushed into the meds without ever finding out what my body is able to do on its own. Do you have any thoughts on whether or not I should stay on the meds? What are the pros and cons of stopping?

Thanks very much. This site is amazingly helpful.

Response from Dr. Conway

I am pleased that you are tolerating the medications and that they are working for you.

Many would advocate considering treatment during early HIV infection (within 6 months after being infected) regardless of the CD4 count for at least 3 important reasons:

1. Your immune system is still intact. 2. The viral reservoirs are not completely established. 3. The virus itself may be more easily controlled by the immune system.

Now if you commit to treatment as you have, some might consider stopping treatment after, say, one year to see if your immune system can control the virus on its own, perhaps indefinitely. There are controlled clinical trials of this concept ongoing right now. Even outside a clinical trial, you may choose to consider stopping therapy. If you do, it would be important to monitor your CD4 count to make sure you don't need to restart soon. If you do, your options for doing so would not be limited in any way, as you would have stopped HAART with an undetectable viral load, never giving the virus a chance to get resistant.

Good luck whatever you decide, and thanks for your kind comments about the site.



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