Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date. According to a news article the average time to death with treatment is six years. Does that mean that since I started treatment two years ago, I will die in four years? By the same token, time to death without treatment is 18 months according to the article. I am on Combivir and Sustiva, have never missed a dose, with VL <50 since the inception of treatment in July 2002, and a CD4 % at around 210 which has risen each 3 months of every checkup since Jul 2002. I am on my first treatment regimen. I feel pretty good, but like any one else, some times I feel sluggish. Is the sluggishness a side effect of the medication? Or does this mean that the regimen is wearing off? Please Help.
Dear Reader:
It sounds like you are reading some very old news articles. The
timetable from treatment to death prior to the arrival of
protease inhibitors and the development of triple drug therapy
in 1996 was about 18 - 24 months after the first opportunistic
infection. And even with treatment 4 to 6 years was about
average.
Now that is no longer the case. In a patient like you - faithful on your first regimen for over three years and a viral load less than 50 - you should go years and years before you might need a second regimen. And then that regimen should carry you for years after that. In fact there is data out on exactly your regimen of Combivir and Sustiva that shows continued viral suppression for 5 years. I view HIV in you as a long term manageable disease. You should plan on decades.
You may be sluggish from the medications. Both sustiva and the
AZT component of Combivir can make you tired. However some
patients with HIV, even though it is fully suppressed, still feel
that they are somewhat low on energy. But this is NOT a sign
that the regimen is failing.
Daniel H. Bowers, M.D.
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