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What should I try next

Aug 7, 2002

My name Joe and I've been on Zerit&Epivir for 6yrs and the new test to see if the meds are working shows that Zerit is only working 4percent in my body.I've been HIV for 10yrs.What would your recomend for me.I havn't tried no other medications. Thank You Joe form Astoria NY

Response from Dr. Boyle

I'm not sure what working 4% means, but I presume you're failing your current regimen and that means you're likely to have resistance to Epivir (184V) and Zerit (NAMs). This means trouble, since these mutations may compromise the nucleoside analogue (NA) "backbone" significantly. If your genotype shows significant NA resistance, I would consider a protease inhibitor (my pick = Kaletra) with a non-nucleoside (my pick = Sustiva/Stocrin) and 1-2 NAs that the virus is most sensitive to. This regimen should work well if taken correctly and with excellent adherence. If your genotype is not that bad regarding NA resistance and you haven't been on any other NAs in the past, you might be able to get away with Kaletra or Sustiva/Stocrin with 2 NAs, and I would discuss the resistance testing results with your doctor and get his/her opinion on where to go from here.

T20 and needles
Combivir and Sustiva

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