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Trizivir plus Sustiva, Versus Combivir plus Sustiva?

Oct 22, 2003

What's the chief benefit of sticking with a Trizivir+Sustiva regimen, versus reducing drug count by switching to Combivir+Sustiva? Adding Sustiva to my Trizivir regimen is in the works but I want to know first if I'm ust better off avoiding abacavir (no reaction to it) if I don't have to have it.

Response from Dr. Young

Great question, but there is no science-based answer.

There is data from the AIDS Clinical Trials Group study 5095 that suggests that even once suppressed, patients who receive Trizivir tend to have more frequent treatment failure than those who are on either Combivir/Sustiva or Trizivir/Sustiva.

This conclusion would support the idea of adding Sustiva to your current regimen, though I've not done this for the patients in my practice who are on Trizivir stand-alone therapy. Is the four drug regimen (Trizivir/Sustiva) better than the three drug regimen (Combivir/Sustiva)? I can't tell you-- there are some that believe that the 4 drug regimen should be more potent, particularly for those persons with high baseline viral loads or very low initial CD4 cell counts.

The reality is that there are so many factors that go into the decision, that in before we see the final results of the 5095 study, we be left to make our best educated (or ignorant) guesses.

Good luck and thanks for reading. BY

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