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first- time drug regimen
Oct 13, 2005

I have a cd4 count of 16 and viral load 500,000+. 39 years old, 5'10", 140lbs, symptoms minimal. My Dr. has perscribed Combivir + Sustiva as first drug treatment. Also received second opinion of Combivir + Kaletra. Please lend your opinion. thanks

Response from Dr. Pierone

You asked for it here it is - your third opinion Norvir, Reyataz, and Truvada.

There is nothing wrong with the first two choices by the way. Both are tried and true and would be expected to work.

In a situation with a very low CD4 count and high viral load there is a legitimate argument that can be made for starting with a more potent boosted PI regimen. However, a Sustiva-based regimen will often work even with a high viral load. The reason I suggested the regimen above is because Truvada is once daily and tends to be better tolerated than Combivir. Also, boosted Reyataz is given once daily, contains fewer pills, and is better tolerated than Kaletra. Again, this is not written in stone because of a dearth of direct comparative studies. But there are some trials underway which will probably help to better treatment decisions in the future. Good luck to you!



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