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substitute abavacir for d4t?

Oct 25, 1999

I am currently on d4t, ddI and Sustiva, and am having problems with neuropathy and facial and limb wasting. I know its not a sure thing that d4t is the primary cause of wasting, we were thinking of taking out the d4t. The obvious substitution is azt, I guess, since its another thymidine analog. But we were also thinking about abacavir, and I was wondering how it fits in with the thymidine/guanasine(sp?) distinction. (I've always heard that it is more like a really strong 3tc. In other words, is it more like azt and d4t or like ddI and 3tc? It sounds like its strong enough that its likely to work in combination with abacavir and sustiva, which is what we are thinking. But I am wondering about resistance down the line, if/when the combo fails. I've always assumed that its better to hit the virus with a thymidine and a guanasine analog. This is all pretty confusing to me; I just dont want to end up with a regimen that limits my options later. Thanks for all your great help here.

Response from Dr. Holodniy

I am not sure that we are that sophisticated yet to know the exact answer to your question. Abacavir is a very potent agent and can work well with sustiva. MH

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