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can i stop zeffix
Jan 31, 2010

iam taking zeffix 100 one daily since 20 monthes and i made 3 pcr all of them negative (zero) it was mistake from my doctor to choose zeffix because iam hiv + but till now my v.l not detected and my cd4 636 (24%). i want to know why zeffix is bad choise for hiv+? what will habend to me after 20 monthes with zeffix? can i stop zeffix specially my all pcr was negative ? if i stop zeffix or change it to adefovir what will habben to my vl and cd4? please tell me every thing because i do not have good doctors in my country. hepatitis doctors here do not know any thing about hiv and also we do not have specialest hiv doctor in my country. please help me. thank u very much.

Response from Dr. McGovern

Zeffix (lamivudine) is active against both HIV and HBV. So since we do not usually treat HIV with only one drug, we do not recommend Zeffix if you only want to treat HBV.

However, if your HIV has been suppressed all this time, then you are not at risk for resistance right now. That is good news. Perhaps your HIV RNA level was so low, that one drug was enough to suppress you.

There are several key questions: for your hepatitis B, are you E antigen positive? If so, did you seroconvert? (eg, did you lose E antigen and gain E antibody). If so, I would treat for at least another 12 months after seroconversion.

If you were E antigen negative, I would continue to treat indefinitely because I would expect your HBV infection to come back again if you stop your medication.

There are some doctors who would recommend staying on HIV/HBV medications from now on, regardless of how good your CD4 count is (and it is great)...One possible combination would be Atripla (tenofovir, emtricitabine and efavirenz all rolled into one pill; the first two medications have activity against both HIV and HBV).

Other considerations you can discuss with your doctor are your liver disease stage and how well you are tolerating medications.



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