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Please share your wisdom
Jun 25, 2006

Dr. Daar,

I hope you answer my question even though this is probably not the appropriate forum for this question. However, I really appreciate your optimism and wisdom when answering others in their pursuit for answers. I hope you can find a moment to shed some light on my question.

First, I was diagnosed in Oct. 2005. My TCell count is 580 and VL is 20K. I have a wonderful HIV specialist here in Orlando, FL who sometimes for this site. He is excellent. He tells me that he believes with the current state of the art treatment in the field of HIV that one who is compliant, takes care of themselves and doesnt get hit with a bus or other unforeseen circumstance that one can expect to live a Normal live expectancy. Do you share that optimism?

What do you see as the next breaks through in HIV treatment and how close to that break through are we?

Last, is there such a thing as a Once a Day pill that will be effective for me when I start treatment. My Geno Type test indicated that I have a strain of HIV that is sensitive to all Drugs.

Thank you in advance for your answer to my question and I look forward to reading your answer.

Response from Dr. Daar

I definitely share your providers optimism and do sincerely believe that people like you who take their medications consistently and work closely with their provider will do very well excellent on treatment and have an excellent chance of life-long viral suppression.

When people in your situation talk about the next big breakthrough I always think about a cure. That would be the ultimate goal of treatment and the next big advance for someone such as yourself that I believe already has a chance to live a normal life with HIV. Unfortunately, I do not foresee a "cure" happening in the near future. However, the next best thing would be complete viral suppression with a very simple, well tolerated regimen. I think for many we have achieved this goal and are continuing to improve upon our success with increasingly convenient dosing of effective therapy. The next big step in this direction will be the soon to be available combination pill of tenofovir (viread), emtricitabine (FTC) and sustiva (efavirenz). This regimen will not be for everyone, but for those who tolerate the medication and suppress their viral load on this combination of drugs it will provide an opportunity to take a single pill once per day. Not a cure, but a major step in the right direction.

As I mentioned, this may not be for everyone and even those that can not use this medications often the alternatives still remain quite simple to take and well tolerated.

For those who have developed drug resistant virus and need new options the next big breakthrough is the availability of new drugs in existing classes, such as new PIs and NNRTIs and even more exciting those in new classes, such as integrase and CCR5 inhibitors, both of which are moving along in clinical trials.

Based upon the above I am hopeful that we may be on the verge of an era in HIV treatment that could reshape the disease, perhaps approaching the events that occurred in 1995 with the availability of PIs. Only time will tell but I am very excited and optimistic!! Best, Eric


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