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."
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.
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