Starting treatment is 3tc/efavirenz/tonofovir a good bet?
Aug 29, 2003
I am asymtomatic HIV+ 33, positive for 2 years. My CD4/VL have been relatively stable although drifting down(for cd4). My last tests were dramatically different VL 700,000 (3months previously 50,000) CD4 203 (280). 18 (28). I am repeating the tests but have been advised to think about starting treatment. It appears that 3tc/efavirenz/tenofovir can be taken as a once daily combo which would suit my work but I am concerned that there has been a clinical study (I think with abacavir) with tenofovir that wasn't so good. Is this a viable option or should I aim for a twice daily regime? (And if so which is the current recommended initial therapy). Is it worth getting resistance testing done before I start ?
Response from Dr. Young
The treatment regimen of tenofovir (Viread)/ 3TC (lamivudine, Viread)/ efavirenz (Sustiva, Stocrin) should be a very well tolerated, simple to take initial drug regimen, assuming that your virus is a fully drug susceptible one. You've mentioned drug resistance testing, and I would encourage you to have this testing done, particularly if you live in the US or Western Europe, where as many as 1 in 8 (or more) newly infected persons have evidence of drug resistance.
The ongoing Gilead 903 clinical trial is evaluating exactly this regimen and has shown excellent potency and tolerability. Given your request for a once-daily treatment regimen, the TDF/3TC/EFV regimen that you mentioned is probably better than other potential once-daily treatments, especially given the fact that the two year data from this study continues to be very supportive. The twice daily options of AZT/3TC/EFV or d4T/3TC/EFV would also be worth considering and both have substantial long-term studies; but if once-daily is where you're at, I think that the tenofovir-based treatment should be fine.
You've mentioned a clinical study that used tenofovir with abacavir (not part of your proposed treatment)-- this was a study presented by Farthing at this years IAS meeting (see TheBody's conference coverage for details). The study looked at the triple nucleoside combo of tenofovir/3TC/abacavir and unfortunately showed very poor results-- suspected because of some yet unknown interaction between the three drugs.
Good health-- BY
Get Email Notifications When This Forum Updates or Subscribe With RSS
- Odds Of Getting HIV Unprotected Vaginal Sex
- Probability Of Getting HIV From Sharing A Razor
- Unprotected Sex Without Ejaculation And HIV Transmission Risk
- Loose Stool Could I Have Acute HIV Infection
- Itchy Rash After Giving Oral Sex Does It Mean I Have HIV
- Pain In Penis After Reused Needle Worried I Have HIV
This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.
Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither TheBody.com nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.