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Mar 13, 2002

Dr. Young,

Is trizivir alone enough to start on? Should I be concerned about resistance down the road?


Response from Dr. Young

Trizivir (AZT/3TC/abacavir) is a very convenient triple coformulated drug. The regimen has shown in several studies to be similar in potency to conventional protease inhibitor-based treatments for initial therapy. There has been some concerns about potency in persons with high (>100,000 copies) viral loads-- this was observed in a placebo-controlled study where patients took protease inhibitor placebo, so the benefit of low pill burden was not realized.

As for resistance, recent studies by Lanier have given us a lot of information about the patterns of resistance that emerge following viral failure of Trizivir-alone therapy. These data seem to indicate that the resistance that evolves early is quite similar to patterns that emerge following AZT/3TC-based treatments; largely resistance to the 3TC component. There is the potential danger that if treatment continued for a longer period of time (after initial failure), that additional nucleoside analogue resistance mutations will arise. This means that follow up lab testing is important, for this as well as other treatments.

In general, I have found the treatment to be very well tolerated and certainly among the most simple of three drug treatments available.

Hope this is helpful, BY

The question: meds or no meds?
is it to late

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