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ADVICE
Apr 21, 2003

HI I WAS DX WITH HIV IN FEBURARY 2003.I JUST RECEIVED MY FIRST LAB RESULTS MY CD4 IS 336 AND MY VIRAL LOAD IS 39.680 MY DOCTOR WANTS TO START ME ON VIRAMUNE AND COMBIVIR I WENT FOR A GENOTYPE TEST BUT DO YOU THINK THAT VIRAMUNE AND COMBIVIR WOULD BE OK AND SHOULD I EVEN START TREATMENT NOW IM A 23 YEAR OLD FEMALE AND YOUR RESPONSE WOULD GREATLY BE APPRECIATED THANK YOU.

Response from Dr. Young

We've been using this combination for many patients for some time-- Combivir/nevirapine should prove to be a very simple, well tolerated drug regimen-- Recently presented results of the so-called "2NN" study compared this to Combivir/efavirenz (Sustiva) and showed very similar results, adding further support for the nevirapine first-line regimen. We tend to avoid the use among persons with preexisting liver disease-- like all medication regimens, clinical and laboratory monitoring is an important element of safety monitoring, and would advise this for you too.

Having a genotype in hand prior to starting is optional, and even knowing the results does not mitigate against the need to follow your viral load response to therapy closely (though I try to get one in the vast majority of patients prior to starting treatment).

Good luck. BY



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