Dec 3, 2001
dear dr. boyle. i hear people saying that hiv is now a chronic disease.it has been stated by my dr he says i can live a full and normal life. well i have been hearing that the drug cocktails only work for about 15 to 10 years. im 46 years old. does this mean that i will be dead when im 56 or 61 years old? im going to start med this week . the med is viracept and combivar. im scared to death on the side effects. my viral load was 26,000 in july of 2001 , and my t-cells were 435 in july as well in 2001. he told me the right way was to wait or to start. how many t-cells does the virus kills per year? does the t-cells come back up after the meds kick in? will i be dead in 15 years even if i take the meds religiously? what are the most common side effects from people on combivar and viracept? im worried about fatigue or nausea. dr i work for american airlines as a baggage handler is this good to keep my exsersise in compliance. i also work out at home every day.please let me know.
Response from Dr. Boyle
Your doctor is right that HIV is now a chronic disease in many patients. There is no reason to expect that you will be dead in 15 years, if you follow your doctor's advice. The current antiretrovirals are very effective and durable if taken without missing doses and there are new, even more potent agents in development that should work even when the virus has become resistant to the old agents. The main side effects of Viracept are diarrhea and gastrointestinal upset. The main side effects of Combivir are nausea, fatigue, headaches, muscle aches and the primary laboratory abnormality is anemia - all of which are related mostly to the Retrovir (zidovudine, AZT) component. As far as when you should start therapy, I am not sure you need to start therapy right now. The DHHS guideline suggest starting therapy when the CD4+ T cell count is between 200-350 or the viral load is >55,000 copies/mL. You should discuss this with your doctor before starting therapy and understand the resons why he wnats to start you on therapy now. Also, you should discuss other potential antiretroviral regimens with your doctor, for example, non-nucleoside based regimens that are simpler and potentially less toxic than the Viracept regimen he is proposing.
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