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When will I need to switch meds?
Apr 20, 2003

Hello, I was hoping you could give me an estimated timeline of how long my current meds might work for me. I was infected in the fall of 2000; by February 2001 my cd4 count had fallen to 71 (yikes!), VL = 64,000, cd4 = 3. I immediately started on Combivir and Sustiva, and have been on these meds ever since. Six months after staring treatment, cd4 had climed to 212, VL = 164, cd4 = 29. As of this month, cd4 is 414, VL undetectable, and cd4 is 32. I am very adherent to my regiment, only missing a dose ever couple of months (if that). I have never had an OI, and am in good health. Any idea how long these meds might continue to work? Is it closer to one year, or closer to 5 years? I have never found a good answer for this. Thanks for your response, JS

Response from Dr. Boyle

The answer is a tough one since sustiva/Stocrin (efavirenz) has only been around for about 5 years. However, modeled data of patients like you (that is, those who get to undetectable on therapy) on the same regimen you are on indicates that the time for 1/2 of the patients to "fail" is about 10 years. So, you can expect the regimen will last a very long time, especially if you take it religiously. Kind of amazing isn't it, considering how bleak things were just a little over 7 years ago.

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