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Switch or leave well enough alone?
Aug 31, 2004

I have been on meds since 1/2004. I am 44 years old. When I started, my viral load was 245,000 and my cd4 was 330 and my cd4% was 9%. I have been on combivir and sustiva. My most recent test at the six month mark was viral load under 50 copies, cd4 486, cd4% 12%. I seem to be tolerating the medicine quite well, with no side affects (with the exception of very slight anemia). Now I hear about the once a day regiments that do not include the AZT which is in combivir. Although I do not have an issue with a twice a day regiment, it really is not that hard to remember, once a day would, of course, be even easier. But my biggest concern is the AZT. I read so much controversy about this particular drug. You hear about all the down side of AZT, and want to know if I should switch? I have spoken to my doctor and he says it is really up to me? Do you have an opinion about combivir versus another once a day treatment without AZT or should I as they say "if it's not broke, don't fix it."

Thank you.

Response from Dr. Lee

If you have an effective regimen, and one with few side effects, you may want to be a little conservative about jumping to other combos with other potential side effects. However, if the ease of once a day is significantly more attractive, there are several treatment options. Review them with your doc.

AZT is not available (and probably won't be formulated) as a once daily treatment. It must be taken every twelve hours in order to maintain the intracellular levels that are necessary to suppress the viral replication. A small percentage of patients develop anemia with AZT. Most other side effects are comparable to those of other nucleoside medicines.

Be well.



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