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RE: FIRST LAB RESULTS.
Apr 13, 2003

DR WOHL, I just read an answer to the question posted by " First Lab Results" that caused me some alarm. I tested positive last May ...6 wks after being infected by my partner. Viral load was 16,000 and t-cells were 800. After several consultations in a very short time period I chose to start Trizivir in hopes of preserving my immune system ( I realize this is a theory). Since then I get tested every 3 months, viral load undectable, t-cells were 1000+, and I am 98 compliant with my medication with no side effects. I realize that HIV research is an evolving animal, and I visit this site almost daily looking for hope. My concern is now, that I have made the wrong choice to start Trizivir based on your information. My greatest fear is not being positive ( well that too) but the thought of drug failure. Should I ask my doctor to change my regimen or wait see what happens with the Trizivir. I realize you can't give medical advice but this forum's opinion counts BIG TIME ! Please let me know what your thoughts are....... Thanks C.T.

Response from Dr. Wohl

Despite Trizivir's shortcomings compared to other regimens in clinical trials, it is important to recognize that most people on the drug do well. How we consider the potency of drugs is relative to others. But in a vacuum we might not think a regimen that gets the majority of those taking the drug undetectable a year later all that bad - until we find out another regimen gets 10% or 15% more of folks to this point.

For some, the convenience and tolerability of Trizivir are positives that outweigh the negatives. You are 98% adherent to Trizivir, maybe you would be 91% adherent to an alternative regimen that outperformed Trizivir in a clinical study - would the alternative be better? I am not sure.

Also, we do not know how well any of these combinations do long term in those with acute HIV, high CD4 cell counts and low viral loads (i.e. you).

That you have done so well so long would, for me, lend support to an 'if it ain't broke, don't fix it' approach. If I were you, I'd talk this over very carefully with my clinician. Discuss your options and ask what she/he would do if they were you. DW



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