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best anti hiv pill combo
Apr 1, 2012

Hi ! I'm a 23 year old male, diagnosed with hiv about a year ago. I have been taking truvada, norvir and prezista for 4 months now. Asside from a rash I had at first, I seem to be tolerating them well.

Which would you say is the best anti-hiv combo, in the long term (possibly one with less pills and the least side-effects)?

Thank you!

Response from Mr. Vergel

Everyone is different and people respond differently to medications, so it is hard to say.

I am assuming that you are on your first antiretroviral combination and that you were not infected with a virus that had resistance mutations to current drugs.

If you are not genetically prone to high cholesterol and/or do not have problems tolerating Norvir, then any boosted protease inhibitor plus Truvada or Epzicom is OK. But this requires at least 3 pills once a day. Prezista is believed to be one of the most potent protease inhibitors.

If you would rather take one pill, then we have Atripla and Complera. The first one has been tested extensively. Complera is newer and there are things that we are still learning about it. Atripla can cause abnormal dreams and dizziness that usually get better with time in most people (not all). Complera so far is not as effective for those with viral loads over 100,000 copies per ml and it requires to be taken with food, but it seems not to have the central nervous system side effects common in Atripla.

Raltegravir (Isentress), an integrase inhibitor, plus Truvada requires dosing twice a day but it has fewer side effects and interactions with other drugs that you may be taking for other conditions. It does not require Norvir.

There will be another once a day drug approved in the near future called QUAD with an integrase inhibitor, a booster and Truvada. Research data shows no abnormal dreams but a higher incidence of nausea and increases in creatinine compared to Atripla or boosted Reyataz plus Truvada.

As I said, it is not a clear decision since there are several factors that your doctor uses to determine what may best work for you.

If you want to get details on every drug, there is no better source than this: Nelson HIV Drug Chart 2012

and

HIV Drug Guide 2012

Nelson



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