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HIV + HBV Treatment
Jan 15, 2008

Hello, I'm 40 y.o., male, diagnosed with both HIV & HBV. I have taken Combivir and Kaletra for a year. HIV and HBV levels are undetectable. Liver function, hemogram and lipid profile are normal. CD4 count is 153. My doctor wants to change my combo for Viread + 3TC + Kaletra. I am concerned about my kidneys and liver after a long term. Blood tests each 4 months are enough to assure a good treatment? Would you recommend such change? Thanks.

Response from Dr. McGovern

I have to say that I agree with your physician's good judgment. Patients with HIV are at risk of developing lamivudine resistance. (Lamivudine is part of Combivir). I think your physician would like to avoid that possibility by giving you two drugs with HBV activity.

With that said, you do have ongoing viral suppression now so your chance of developing resistance is less than someone who is on lamivudine with ongoing virus detection. However, if there is viral breakthrough, liver tests can become elevated.

The risk of kidney problems with Viread are low in patients without preexisting kidney problems. Blood tests every four months would be a good plan. I would also check a urinalysis before starting to be certain you do not have any protein in your urine.



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