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Dr. Cohen
Mar 31, 2002

Dr. Cohen: I may undergo HAART soon So my question is this: does the 3-in-one meds contain all that is needed to repress HIV with out taking any other pills? This would fit into my work pattern, which can be very erratic. Thanks you, Declan

Response from Dr. Cohen

Declan - you may have already started a combo, but here are some thoughts.

You refer to the medication combo called "trizivir" - which has three different antivirals all in one tablet - taken as one tab twice a day. And yes, the research done so far does indicate it can be enough just on its own. It has been as if not more successful than some of the standard combinations we have used - including those based on a protease inhibitor. And for some, the simplicity of just one tablet twice a day adds a convenience that is important to improving the success rates.

There are some concerns still noted however. For example, it is of "standard" potency - but for those whose viral load are very very high, somewhere above 100,000 (or even above 250,000) it may be less successful than a few other triple combinations we might choose. And similarly, if the Cd4 count is somewhere below 200, there are concerns that it may not be the best choice compared to others. We sometimes trade this slightly less potent approach however for the convenience especially IF someone does not need the added potency. There can be other issues to consider as well - for example each of the meds can have their own side effects. One of them - AZT - can cause some nausea. Ziagen - can be difficult initially for the 5% or so who are allergic to it.

But it is an important option to have. For some, especially for those who find that pill burden is the key challenge, taking just one pill in the AM, and a second one that night, is about as simple in pill burden as we have for now.

Note that we are also making progress in once a day pill taking - we've gotten that approach down to as few pills as just 4 tablets once a day. That would include combinations such as ddI-EC, 3TC, and the new formulation of Sustiva, which is now available as a single 600 mg tablet.

But if one pill AM and PM works for you - and if your numbers are not at the edges of predicted success for this med - then Trizivir can be a great option for you.

Let us know if it worked out.



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