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Viread + Videx + Norvir + Lexiva

Jun 5, 2005

Recently started meds, I've been reading up on the problems with videx viread. I've just started treatment of videx ec, viread, norvir, and lexiva. Should i be concerned with this combination (what's the known risks)?

Thx, Chris

Response from Dr. Wohl

Dear Chris,

Your combo is a bit unusual. That is not to say it won't work but there are other regimens that have more data to support their use.

As you allude to, the combo of Viread (tenofovir) and Videx (ddI) when part of a regimen containing a non-nucleoside such as Sustiva (efavirenz) has been found to be suboptimal with virologic failure and resistance developing rapidly.

It is thought that a cascade of mutations involving ddI and efavirenz is responsible at least in part for the vulnerability of such a regimen. If so, ddI + tenofovir + a protease inhibitor such as Lexiva may not share the same weakness.

I think sticking with a regimen with more data behind it - along the line of Truvada or tenofovir + 3TC plus ritonavir boosted Lexiva - makes more sense.


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