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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
           
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JUST BEEN DIAGONOSED WHAT MEDS DO YOUR RECOMMEND TO AVOID LIPOATROPHY AND SIDE EFFECTS
Mar 4, 2010

Dear Dr. Henry,

Hello to you and all the wonderful doctors and the great staff of the Body that is doing so much to help humanity to relieve pain and suffering. May God bless you all. This is a great site and I congratulate everyone who works on it. It is fantastic. Great Job!

My question is I just found out last week that I am HIV+. My T Cell count is 450. My viral load is 15925.

According to the results I do have I do not show resistence to most medications right now.

I have been assigned to see an infectious disease specialist for the first time in March. I have not received treatment of any type yet.

My questions are as follows:

1. Which drugs should I take THAT WILL NOT PRODUCE LIPOATROPHY? OR IN OTHER WORDS WHICH ARE LIPO FRIENDLY DRUGS? I am really concerned about the psychological impact this might have on me since I already suffer from severe depression. I am on anti-depressants right now.

2. What class of drugs do you personally recommend: NNRTI's?, NRTI's?, PI's?, INSTI's? Early Inhibitors's? (ex. Selzentry & Fuzeon), Integrase Inhibitor's (Ex. Isentress).

3. I heard most drugs now include Ritonavir as a booster is always recommended?

4. Can you recommend an ALL IN ONE PILL SUCH AS THE OFFERED BY GILEAD such as Atripla, Truvada, and Viread. I would like to take as few pills everyday as possible. What do you think? Is this possible or not?

Thank you and may God bless you for your great work to help humanity.

Response from Dr. Henry

I do not have a blanket recommendation for which HIV regimen to start with. That depends on individual factors (female/? wanting to have children, presence of hepatitis B, renal status, risk for heart disease, other medical conditions). I frequently start patients on boosted PI based regimens, Sustiva based regimens (such as the one pill a day Atripla), and increasingly on raltegravir based regimens. All of them have a generally low risk for serious fat loss (each px is monitored for that). I also often enroll patients in research studies evaluating novel regimens or new drugs in order to keep adding to our choices and improving upon the already generally good outcomes seen with current regimens. KH



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