I started treatment 6 month ago have been taking Sustiva/Truvada after resistence testing Started with VL >100000 and CD4 246 18%. Since then my VL has fallen to 200, my CD4 went up to 350 25% 3 month ago but is now back to 240 18%. My doctor wants me change the Sustiva for a boosted PI. The thought of being on the toilet constantly and lossing fat on my face,legs etc terrifies me. What is your opinion I wanted to wait a couple of more months to see if anything gets better. Does this mean that by first line regime has failed already. This is freaking me out. If I do have to change what boosted PI would you recommend with as few side effects as possible please. Your advice is much appreciated.

If you have resistance to Sustiva a change is generally warranted. I use a lot of boosted protease inhibitors-in fact-generally prefer over Sustiva based regimens. I can generally find a boosted PI regimen than the patient tolerates over the long run. There are many choices and many of the newer regimens have less stomach side effects then the early regimens. KH