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Restarting Treatment
Feb 11, 2003

I have been off medication for over a year and my viral load has gone up marginally (30,000 now is the highest). The point that is more alarming to me is that my CD4 counts have plummeted (700 a year ago and 300 now). I have resistance to the 'sustiva' class of drugs (sorry if my terminology is off), so they are out. My doctor has recommended Kaletra, Ziagen, and Zerit. My former regimine was Zerit, Ziagen, and Epivir which did quite well (have viral resistence to Epivir now per last Genotype test). Is this a good regimine? I only ask because the former one was fairly side effect free

Response from Dr. Young

Thanks for your question.

It's difficult to answer your question in detail, not having all the nuances to your medical history; nevertheless, the combination of abacavir/stavudine/Kaletra should be an effective next drug regimen for someone with resistance to NNRTIs and lamivudine (3TC, Epivir). As for why not to use stavudine/abacavir/epivir, I would agree not to use this if you have documented resistance to lamivudine, since this might weaken the regimen and cause premature treatment failure.

Either way, the goal is to find a side effect free regimen; I'd work with your doctor to make sure that whatever the next regimen ultimately is, that side effects are acceptable.

Good luck. -BY

P24negative - response
Sustiva causing resistance to other nNRTIs

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