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Ask Dr. Kaiser Question: Thank you so much for this forum. I have been on Sustiva and it is not working anymore. My doc wants me to go on a protese inhibitor. Are there any other NNRTI (Non-nucleoside Reverse Transcriptase Inhibitor) drugs that I can take before going on a protese inhibitor? I am healthy. My T cell count is 750 and my viral load is around 10,000 copies/ml.Dr. Kaiser replies: I believe that you have a number of good options. First of all, if your CD4 count is remaining stable in the 600-800 range I would recommend that you delay switching your antiviral program. The immune system can tolerate a viral load below 20,000 copies pretty well and as long as your CD4 count is remaining stable, your immune system remains healthy. Second, there may be a number of non-drug interventions that can help bring down your viral load. For instance, are you taking the vitamin program that I recommend 2x/day? Have you been checked for intestinal parasites within the past year? And are you exercising and maintaining your muscle mass in the 40-44% range (as determined by a BIA test) with the help of adequate protein and hormone supplements? If not, these are a few measures that can help insure that you get the greatest durability from your current antiviral medications. Remember, the greater amount of time without switching your antiviral regimen prematurely, the more new options will become available for use down in the near future. And by the way, a new 2nd generation class of NNRTI's will be available within a couple of years that will work even when the originals (Sustivia, and Viramune) have lost their beneficial effects. Good luck! Check out our Message Board! |
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