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TRIZIVIR part IV
Jun 25, 2003

Hello Dr! long time since I last posted! :)

Follow up on "starting trizivir" 6/4/2002,8/23/2002,9/25/2002. Treatment naive,29 y.o.(at the time of starting treatment) Been poz since dec 98. As of beginning of treatment (june)VL= 57000 CD4 =257. After 6 weeks of trizivir VL=172 CD4= 335. September 2002 VL= under 50 copies/ml cd4=474. June 2003 VL= under 50 copies/ml CD4=540.

This is just to give a follow-up. I am lucky to have a great response to trizivir, also adherence is easy once you see the results (it encourages a lot). Everything else on the blood test is around normal levels, so I am a happy camper. The nausea is gone (no more Linda Blair) thanks to your tips on eating and also (hear this!) ACCUPRESSURE. I found an accupressure spot that magically stop nausea.(this may not work for everyone but it DID work for me)

My questions now: How is this "Trizivir-once-a-day" thing going? is it safe yet? or is it just an invitation to mutations?

any news on treatment interruptions? do they serve any purpose ? (I mean the "auto vaccination" some people wishes to accomplish)

And finally: any new things in the pipeline ? (did someone came up with fusion inhibitors on a pill at least?)

Well.Thanks again to the people of the body for keeping this working in exellent shape.

Response from Dr. Young

Thanks for the update-- it's great to hear that you're doing well and the side effects have improved.

Trizivir once-a-day is probably not going to make it as a recommended regimen; the metabolism of AZT won't support this kind of dosing (at least at the moment). As such, I would not recommend this approach. If once-daily is really important for you (sufficient to abandon your simple two-pill-a-day regimen), there are once-daily options that might be worth discussing with your doctor.

I'm a fan of the ain't broke-don't fix strategy, so unless there is a dramatic change in your adherence or side effects, I'd sit tight. Recent data does raise questions about the potency of Trizivir-alone versus efavirenz (Sustiva) based therapies, and in light of this, I'd want to make sure that your viral load remains below 50 copies. If there is evidence of even low level viral replication, I'd make sure that your doctor followed up on this result.

As for treatment interruptions, there is new data-- mostly not too encouraging, with regard to auto vaccination. (Surf over to TheBody's conference coverage).

There is a lot new in the pipeline and approved drugs as of June 2003-- enfuvirtide is finally here (though, yes it is injectable) and atazanavir (a once-daily protease inhibitor) is also approved for use. There are quite a number of other products in various stages of development-- new PIs, new NNRTIs, new NRTIs and very early work on an integrase inhibitor and orally available fusion (or entry) inhibitors. Stay tuned, there will certainly be more in the future.

Thanks again for the follow up and the warm comments. Good luck. BY



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