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Choosing Your MedsChoosing Your Meds
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Second Opinion
Dec 17, 2002

In advance, thank you for your response. I have been on Sustiva, Zerit, Epivir and Videx for the past four years and this combo is my initial combo. I am allergic to Ziagen. My counts are a continued VL of 100 or less, CD4 1200 (30) but a continued cholesterol rise and some lipodystrophy. My physician has added Lipitor 20mg and suggest that I might take a break from meds. I would love to give my body a break from the toxicity of the meds but do not want to jeapordize my future. Could you please give me your thoughts on this suggestion. I am very concerned about the lipodystrophy and cholesterol count as I come from a family of Heart Disease. Once again, thank you.

Jon in Kansas City

Response from Dr. Boyle

The studies that have looked at treatment interruptions indicate that the best predictor of how a person will do is the nadir (lowest) CD4 count they ever had. If your lowest CD4 count was >350, an interruption should be pretty safe; if between 200-350, it may still be safe but you should be monitored very carefully; and if <200 it's probably a bad idea. Balancing potential (or real) toxicities with continued virologic control/immunologic function is sometimes difficult, and each person needs to weight the risks and benefits for themselves. Furhter information about this can be found on this website.

few side effects: Zerit, Viracept, & Epivir
Changing treatments: help needed!

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