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Epzicom vs. Truvada with Boosted Reyataz
Aug 21, 2007

Because the Viread in Truvada reduces the level of Reyataz in the bloodstream, could it be better to take Epzicom with Reyataz (provided one has had the HLA-B test and is not hypersensitive to Ziagen)? It seems that even with boosted Reyataz, the use of Epzicom would result in higher Reyataz levels. Do you have a preference of which NRTI combo to use with boosted Reyataz? Thanks.

Response from Dr. Young

Thanks for your post.

You raise some very cogent points about drug interactions. There aren't any fully powered studies that address this issue. Because of this, the relevancy of the reduction of atazanavir (Reyataz) levels with tenofovir (Viread, Truvada) remain theoretical.

It's seems clear that boosted atazanavir with either nuke combo works well in therapy naive persons. I think that the real difference in the two might be seen where the regimen's potency might be compromised- this could be because of low-level resistance or when the atazanavir levels are further compromised by taking the medication on an empty stomach or with anatacids.

With the new HLA genetic testing to reduce the risk of abacavir hypersensitivity (Ziagen, part of Epzicom), the combination of Epzicom with boosted 'taz makes a lot of sense to me. We've had quite a bit of success recently with the combination.

Just my .02. BY

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