|Epivir & Zerit to Trizivir?
Apr 2, 2001
I have been on Epivir, Zerit and Sustiva for about a year and a half now. My viral load has come down significantly, but in the last 6 months it has been trending back up (24 to 126 to 243). My doctor wants me to drop the Epivir & Zerit and instead take Trizivir with the Sustiva. My question is, do you think this is a good idea? Other than the potential problems with the Ziagen in the Trizivir, is there anything else that I should be worried about before switching?
| Response from Dr. Boyle
Your viral load is in an area where some clinicians continue the same therapy with careful monitoring of your viral load and CD4+ cell count, other clinicians choose to intensify your therapy by adding another antiretroviral, and still other clinicians choose to change the regimen completely. I am not sure I agree with the change to Trizivir since the drug most likely to be failing in your regimen is Epivir and that, of course, is a part of Trizivir. Further, Trizivir (which contains Epivir, AZT and abacavir/Ziagen) is not as well tolerated as Zerit and Epivir, due to AZT-related nausea, fatigue and other symptoms, which are common, and potential abacavir hypersensitivity (which occurs in 5-6% of patients). Also, if you have ever been on AZT in the past, this change is unlikley to be as effective. If you are going to change, there are a number of other options, e.g., intensifying with abacavir/Ziagen alone, or discontinuing the Epivir and adding ddI (Videx EC) and abacavir/Ziagen, or discontinuing the Zerit and epivir and adding ddI and AZT. BB
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