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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
           
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To start or not to start?
Jul 4, 2005

I've just been diagnosed with HIV (Viral Load 48000, CD4 cell count 575). My doctor is recommending aggressive treatment with Truvada and Sustiva. I'm scared of the side effects I've read about from Sustiva. Any suggestions? Should I consider holding off starting meds?

Response from Dr. Conway

In many cases, we are now holding off on treatment in people such as yourself, with a well preserved immune system, and a relatively modest viral load. The reason for holding off is that your risk of disease progression over the next number of years is fairly low, and the risk of treatment (side effects, development of drug resistance) are higher, relatively speaking. In some people with acute or recent HIV infection, we are recommending that treatment be considered, irrespective of CD4 count and viral load. This may be the case for you. However, you need to be clear as to why your doctor is recommending you start and what the consequences of waiting might be.

The selection of individual regimens would then follow, based on what is most important to you, in terms of pill count, frequency of administration and side effects. There are many correct choices (including Truvada/Sustiva), just make sure you are comfortable with what ends up being decided, as you are the one that is having to take them...



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