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Videx, 3TC, Viread Article
Oct 27, 2003

To my favorite online doctor: I read an article today where it is now discouraged to take Videx, 3TC, and Viread together due to the high failure rate. I have periodically kept you up to date (since last February) with regard to my success around Videx (250MG), Viread and Sustiva. In fact, you gave me the knowledge to lower the Videx dose from 400MG to 250MG. Anyway, I continue to remain undetectable with my Tcells hovering between 1000 to 1450. You had once mentioned that even though there are not a lot of studies proving this combination, you stated it most likely is a 'potent' combination. I am curious to know if you opinion has changed since, or if you have any new reserversation with this news about 3TC (even though I dont take that...I take Sustiva). Should I be concerned? I continue to take my current combination once a day without regard to food and have not missed a dose in about 1 year (which was only due to a stomach virus) Thanks.

Response from Dr. Young

Thank you for your post.

The article that your doctor refers to concerns to clinical studies that used the combination of ddI/3TC/tenofovir. These two studies (presented by Farthing at this summer's International AIDS Society meeting and DeJesus at this Fall's ICAAC meeting-- see TheBody's conference coverage for details), pertains only to this triple nuke combination, and showed that this triple regimen does not perform as well as we had expected, and less well than the combination of Combivir/efavirenz (Sustiva, Stocrin). These studies should not be extended to refer to other regimens that include two of the three drugs in the regimen (like ddI/tenofovir/efavirenz, as your taking), but might raise, minimally, a cautionary note.

My opinion remains the same, that the combo that you're taking should be potent; though I would have favored using one of a more proven combo, such as TDF/3TC/efavirenz or ddI/3TC or ddI/FTC/efavirenz-- if the need to be on an entirely once-daily regimen is essential.

Provided that your CD4 count remains high and your viral load undetectable, there is not much to worry about. The key thing here is to understand your risk aversion-- if you're doing well, and believe in the aint-broke-don't fix philosophy, then continue to monitor. If not, then you have some alternative, proven combos to discuss with your doctor.

Good luck and thanks for reading. BY



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