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Combivir & Tenofovir

Nov 26, 2006

Hi, I've been taking Combivir and Tenofovir for 3 years as my first combination. It seems to work for me, viral load below 50 and CD4 count of 700+ for virtually all that time. My Consultant mentioned they dont use this as a first combination anymore, and I cant find any articles that discuss these two drugs as a combo. Can you tell me why it fell out of favour and does it have any implications for my future options. When this combo fails will it limit my future choices? Is this combo associated with any particular long term side effects? I am just concered because I seem to be having memory and fatigue problems, I'm getting fatter around my upper stomach and no where else. Not sure if these are natural changes due to my age, 34, or long term use of these drugs. Many thanks.

Response from Dr. Pierone

Several years ago multiple studies were done with different triple nucleoside regimens and most of them demonstrated underperformance compared with NNRTI-based HAART. Interestingly, there were some small studies of Combivir and tenofovir (Viread) which actually showed reasonably good results. But again, based on the overall literature showing inferior outcomes with triple nuke therapy, the regimen you are on never gained much traction and is not commonly used. This may also have to do with the movement away from the use of AZT because of its greater risk of side effects.

It is sometimes hard to sort out aging issues from medication effects, but 34 years is still very young. My first thought would be to blame the medications for your symptoms and consider stopping or switching. Since you do not have virologic failure on this regimen there are no major implications on choice of future therapy. Let us know what you and your Consultant decide to do and how things go. Good luck!

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