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less annoying HIV cocktails
Apr 12, 2004

doc, in the early 80s, azt was the only drug & overdosed but people always said then as they do now, follow what ur doc. says. i'm not trying to be a wiseguy in asking this but here goes: what's wrong with switching meds every 6 mths so you dont become immune(resistant?)to them, like roach poison for roaches? i know the docs of the 80s say that if you switch so often you'll become resistant more easily & they may be rt., but what about switching every month even. these drugs stay in one's blood stream for at least a week after stopping them. anyhow, is the "resistance" factor the only reason one should NOT switch monthly? And 2, why use more potent drugs if side effects will ruin quality-of-life? Is QUANTITY-of-life considered more important and QUALITY. From everything i read, it seems like that's the underlying presupposition. It's as if the underlying theme is "You'll live with stomach cramps till ur 80, if u stay on these 2 protease inhibitors," the most potent-for-me drugs. Are newer drugs becoming more potent against HIV and less potent in side effects against people and what are they? i know i sound beligerent but i dont mean to be. it gets my questions' points across faster (or so i think).

Response from Dr. Pierone

Switching HIV meds like so you don't get resistance like they switch roach poisons for roaches? (the roach part brings back fond memories of my early childhood in Newark)

Well, this bears out the famous quotation "There is nothing new under the sun". Your idea has actually already been tested (not on roaches, though), and it seemed to work. The study was called Swatch (not the watch, Swatch) and in this trial the idea was to switch HIV regimen on a predetermined schedule.

They studied 3 groups of patients. Group one was treated with Zerit, Videx, Sustiva (we would not use this combination nowadays, too toxic). Group two received Retrovir, Epivir, and Viracept. The third group, the Swatchers, alternated between the two regimens every 3 months. The results were similar overall, but the swatchers were less likely to develop virologic failure, athough the reason why is not clear.

Your larger question was about qualitiy of life vs quantity of life was answered by Cal Cohen on the Switching/Simplifying forum, here is the link , his reply is well worth re-reading. Thanks for posting.

Higher CD4 numbers, percentage and CD4/CD8 ratio in late afternoon versus late morning?
other uses for HIV drugs?

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