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Best prescribed drug combination?
Oct 13, 2005

My doctor has prescribed epzicom and sustiva as my first HIV medications. I only hope that this combination has had positive clinical results as there are so many medications out there to choose from. What do you think of this prescribed combination? My latest CD4+ level was 529 and VL 5415. Six months prior, the numbers were 649 and 1400. I would appreciate any comments on my prescribed treatment.

Response from Dr. Pierone

My concern about the combination of Epzicom and Sustiva is that it may sometimes be difficult to distinguish abacavir hypersensitivity rash from a rash related to Sustiva. With an abacavir hypersensitivity rash the medication must be stopped, whereas with a Sustiva rash (if not severe) the medication can often be continued.

The larger question is whether treatment is necessary at all with such a high CD4 count and low viral load. You can reference previous discussions on this forum about the pros and cons of early therapy. I have no objections to deviating from authoritative guidelines as long as my patient is aware of prevailing and countervailing arguments (blah, blah, blah) and decides to go with early aggressive therapy (or late non-aggressive therapy if that's what they decide). Hope that this helps and best of luck to you!

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