I will be 73 next month and I am thinking of changing my HAART meds. My doctor recommends it, but is not insisting on it. I am doing quite well on my present meds, Combivir and Veramune which I have used ever since I was diagnosed 5 1/2 years ago. At 4 weeks I was undetectable and my Tcells were 650 (28%). My Tcells have been about the same and I have remained undetectable and I have had no side effects. So what's the problem? KS. A lesion on my right ankle was the symptom which prompted my first visit to the doctor. It was KS. Over the last 5 1/2 yrs, the KS has pretty much appeared in the right ankle area, except for two on the right knee. All told, I've had about 18 lesions, a few cropping up about every 8 months. Most all have been small pimple sized, but 2-3 about 4-5 mm. Four have actually gradually disappeared on their own and the others were treated with radiation, and 2 by "burning" them with a spray from a can ( I forgot the name of the chemical!) and now I am using Panetrin. I am Jewish and I know there is a higher chance for KS among male Jews, Ashkenazi. The problem is the KS have been appearing more frequently in the last year. My doctor tells me that if I switch to a protease inhibitor, most likely there would a remission of the KS. I am afraid of the side effects that might result with a PI. What do you think? Should I stick to my present meds which produced no side effects so far and see how much the KS develops and make a decision later? Or should I go for the likelihood of putting the KS into remission, but risking side effects? And what meds would you recommend in order to deal with the KS? Oh yes, otherwise my health is good, and I don't drink or smoke. I do have osteopenia, but am taking no meds, only the HAART. And am a maniac for healthy food. Thanks so much!

Thank you for your post.

This is a very interesting question that does intermittently come up in clinical practice. In other words, are there situations where one class of drugs may be better than another in a select situation. With regards to KS, it has been speculated that PIs may be better than NNRTIs (e.g. as viramune). That being said, I do not believe the data is terribly convincing. Based upon that you should talk to your provider about this and decide if it is worth a try. The bottom line is that you should do well on a PI. If new side effects are signficant, or if it doesn't change your KS and you want to go back to viramune you sshould be able to without a problem.

Best, Eric