I've been on Zerit, Epivir and Viramune for approx. 5 years with viral load < 50 and t-cells between 400-600 (and percantage at approx. 37). I've never changed my regimine but over time have noticed (i) pouchy stomach and (ii) veiny arms and legs. My doc suggested maybe switching from Zerit to Ziagen or Viread. He thought that there was more research on Ziagen but didn't dis-saude me from considering Viread. Do you have any thoughts or reasons why I shouldn't consider switching to one or the other based on my history? And if not, is one particularly better? Thank you and thanks for the serivce you are providing!

The evidence for switching from Zerit to Ziagen and regaining fat is derived from 3 randomised controlled studies plus several large cohorts. It is the highest quality 'level of evidence' we have. Data with switching to viread are more sketchy and anecdotal although a large comparative trial of ziagen vs. viread switch will complete late this year. Viread has not been associate with fat loss over 3 years in a large prospective study so we expect it to facilitate fat recovery. Viread also seems to lead to cholesterol and triglyceride improvements which are not so evident with abacavir. Abacavir has an allergic reaction which ocurs in 5 % of recipients whereas viread is generally a well tolerated drug. So the choice lies in greater evidence for ziagen vs. a slightly better tolerated drug in viread. Both can be given QD.

I hope this helps inform your choice

Regards

Graeme Moyle