Nov 2, 2003
Dr. Wohl, My Dr. wants me to start meds soon. My CD4 count is hovering between 350 and 320. My VL is 16,000 and my percentage is 16. He said I'm ready to start and suggested starting before I start seeing symptoms. I was tested for resistance and I have all options open to me at this time. He mentioned some starting regiments, most incluting Sustiva. One regimen he suggested was Trizivir. He stated that studies show that by taking this, I will still have a multitude of options should I develop resistance. I'm not sure if I want to start with this as it seems very dangerous from what I have read...Hypertension which may lead to quick death. How does this medication keep my options open should I develop resistance? Is this a three in one treatment?
Response from Dr. Wohl
Evolving data indicate that triple nuke regimens are not as potent or durable as regimens which include a non-nucleoside reverse transcriptase inhibitor (e.g. Sustiva or Viramune) or a protease inhibitor.
While triple nuke therapy may arguably provide increased opportunities for subsequent therapy, you are more likely to need subsequent treatment with this initial approach.
As far as toxicity, Trizivir has actually proven itself to be well tolerated. Abacavir can lead to a hypersensitivity reaction (sort of like an allergic reaction) in 5-10% of people but this remits with withdrawal of the drug.
Triple nukes with a non-nuke or a protease inhibitor may be fine as an aggressive strategy. DW
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