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Is this OK? What next? - Followup
Sep 19, 2005

Dr Benjamin, I am concerned with tenofovir + ddI as well, but when I switched to this, it was because of side effects not viral failure, therefore, there was no "initial response of 95% drop in ~4weeks", viral load remained undetectable with med changes. I don't like Videx due to possible wasting issues, and as you indicated, toxicity and possible viral failure. Based on previous history, what would you change my meds to, if the decision was to change before viral failure?

Response from Dr. Young

Thanks for the follow up.

If your viral load is undetectable, this is an easier discussion. One simple switch would be to replace the ddI (Videx) with either 3TC or FTC. The later could permit the use of the fixed-dose combination, Truvada.

A rationale behind this approach is that 3TC or FTC will retain some activity even if you have had previous resistance and moreover, these drugs tend to enhance the activity of tenofovir.

Tenfovir/3TC or tenofovir/FTC should be very well tolerated and not have overlapping side effects or toxicity with the tenofovir/ddI combo that your currently taking.

I hope this helps, BY



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