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more info on Truvada, Norivir, Reyataz combo
Apr 15, 2007

Hello, I am a treatment niave patient and my doc wants to start me on the Truvada, Reyataz, Norivir combo...could I get alittle bot more information about that combo (like how well it works, side effects especially lipo, and is this a good combo to start with) thanks..

Response from Dr. Wohl

This is a very attractive combo. It is a once a day regimen. The pill count is relatively low and it includes drugs that have been generally well tolerated. This combo is listed in the US government guidelines for initial treatment of HIV as one of the "preferred" regimens.

Remarkably, though, there are thus far no large clinical studies of this combo in previously treatment patients. One such study is being conducted by the US AIDS Clinical Trials Group (ACTG). So, how did this regimen come as far and become as popular as it has? Extrapolation. That is, the connecting of the dots to predict what will happen. This combo has been looked at in treatment experienced patients changing therapy. In addition, similar but not identical combinations have been studies in treatment inexperienced patients and all these studies point to a nice antiviral effect.

As far as side effects, the major one is high bilirubin but this seems to be basically harmless and an unusual cause for treatment to be stopped.

There are not a lot of data about Reyataz and body shape yet. The ACTG study is collecting data on this. Tenofovir is known to be relatively very safe when it comes to body shape and lipids. Reyataz without Norvir has almost no effect on lipids but the combo of Norvir and Reyataz will increase cholesterol and triglycerides somewhat - albeit usually not to very high levels.

So, all in all, I think this is a very attractive regimen. There are certainly other attractive regimens. There may be a reason you doc prefers this one for you. Ask her/him why. It may help you understand their rationale and allay any concerns you may have about starting meds.

DW



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