Question:

I was diagnosed HIV positive a year ago. My T-cell count has ranged from 285 to 400. Right now, it is about 316 or 25%. My viral load has ranged anywhere from 40,000 to 300,000. Right now it is about 185,000.

I have been very healthy and have not had to deal with the side effects of meds. I read a recent article about the benefits of treating early. Is there any new evidence that says that I should start therapy early? I have had irritable bowel syndrome for most of my adult life and I'm very concerned about HIV meds making it even worse. I am also very concerned about facial wasting and lipodystrophy. If I were to start meds, is there a certain combination that you would recommend that is least likely to have the side effects mentioned above?

I really appreciate your advice.....thank you.

Answer provided by:

Douglas T. Dieterich, M. D.
Chief of Gastroenterology and Hepatology
Cabrini Medical Center
Assoc. Prof. of Medicine NYU School of Medicine

Sounds like with those viral loads you should be taking some treatment. You might want to stay away from the ones that cause diarrhea most commonly like nelfinavir, although, the new formulation is supposed to be much better about that. The facial wasting is most commonly caused by the "D" drugs-ddI, d4T and ddC. You might want to avoid them too. There are many drugs available to treat HIV and some combinations can be used once per day !

Good luck and make sure you take all your meds when you start!

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