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Answers from Dr. Kaiser Question: I have been HIV+ and HEP B+ for 22+ years. My HIV status is thatI am a long term non-progressor and my viral load has never been over 3000 and my CD4 count has never been < 500 cells. I have just been told that my Hep B viral load is at > 500 Million and my ALT is 1425. My doctor wants to put me on Viread, Epivir and Videx. Do you have any experience in treating people with both HIV and Hep B? And what other things should I be doing? Dr. Kaiser replies: Your situation presents a very interesting question. Since your CD4 count has remained over 500 cells and your viral load has never gone above 3000 copies, you technically do not need HIV antiviral therapy. However, your Hepatitis B infection definitely does qualify for standard antiviral therapy. Again technically speaking, your Hepatitis B treatment would at most require the use of two anti-Hep B medications (Viread and Epivir). These work extremely well together and are two of the safest antiviral medications on the market. The real question is, with such good HIV numbers, do you really require a third antiviral drug that will contribute nothing to your Hepatitis B treatment (Videx has no effect on Hep B infections)? In my opinion, you would do fine to treat both your infections with just Viread and Epivir. This would allow you to effectively treat both infections, avoid any additional toxicity the Videx might bring, and save the Videx for subsequent use to treat your HIV infection should you need it down the road. I know that this is not the standard approach, however I have had excellent success using two drug regimens to treat mild HIV infection if the patient follows the other immune supportive recommendations in my book Healing HIV, including vitamin therapy, increased protein intake, eliminating intestinal parasites, and a regular program of exercise and stress reduction. Do not take any measures without the support of your regular treating physician. I wish you the best of luck in your treatment. |
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