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Going back on meds
Jun 23, 2002

I soon need to go back on meds. I am not resistant to anything. My doctor is suggesting Viracep, 3tc, d4t and Ziagen.

Is this a strong enough combination considering that I have a viral load of over 700,000?

If not please offer some alternatives. I cannot take ritonovir, AZT, crixivan and viramune due to side effects.

Thanks

Response from Dr. Young

Thanks for your question.

This regimen should be a very potent regimen- though a detailed answer would require knowledge about what drugs you've been on in the past, and whether there was any concern about the presence of drug resistance.

We know that triple nucleoside regimens (AZT, 3TC, abacavir) are quite potent and usually well tolerated-- there is little data about alternative triple nuke regimens, but it would be very reasonable to think that substituting d4T for AZT would be roughly equivalent.

The addition of nelfinavir to this regimen should definately increase the potency- and address the concerns about triple nuke potency in persons with high viral loads, like yourself.

Other possible medications to consider (without a strong basis for specific recommendation for you) might be tenofovir, ddI, and one of the boosted PI regimens, such as Kaletra (usually better tolerated than other boosted PIs).

Good luck. -BY



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