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May 8, 2001

As a 16 year survivor, no history of meds and about to start meds with a viral load of 41,000 and tcells of 104 with no opportunistic infections. Any hints of what meds to start with? I hear 2 non-nukes might be best. Any info would be greatly appreciated...Thanks!

Response from Dr. Young

thanks for your questions.

I'm glad that you wrote, because, although there are many approaches to the initial choices in therapy for HIV, dual non-nukes is definately not one that is recommended by any organization or by me.

Our typical approach to initial therapy is to use two nukes (either AZT/3TC or d4T/3TC) with a non-nuke (usually efavirenz, sometimes nevirapine) or with a protease inhibitor (usually nelfinavir, but dual or boosted PIs are also figuring in).

The pro's and cons of any particular approach are probably best discussed with your doctor, since the best regimen for you might not be the best regimen for someone else- the decision is very individualized and tailored to fit your needs. Either way, I'd start with a 3 or 4 drug regimen.

Good luck,BY

Lactic Acidosis

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