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Viracept recall, changing all meds or just PI?
Jul 26, 2007

Im on Viracept and Combivir for 8 years and undetectable and between 500 and 700 CD4 during that time. After the recall of Viracept should I change only the PI (e.g. Kaletra) or is it safe to change more meds like for Kivexa/Sustiva; Trizivir/Sustiva; Kaletra/Kivexa; i.e. PI/NRTI or NRTI/NNRTI). the main point to consider for me by making this choice is to keep future treatment options. Thank you very much and best wishes from Europe

Response from Dr. Pierone

Hello, and thanks for posting.

I am not a big fan of switching from AZT to abacavir (Ziagen, Kixiva) because of the potential risk of abacavir hypersensitivity reaction (about 7 percent risk, but rarely fatal). So if tenofovir (Viread) is not available would simply change the Viracept to Sustiva. There are quite a few studies showing the safety and efficacy of protease inhibitor to NNRTI switch so the precedent is there. Changing to Kaletra is fine as well, but it tends to have more side effects than Sustiva. Your future treatment options would only change if you developed resistance to HIV medications and based on your 8 year success on Viracept and Combivir this does not sound like it will be a problem for you.

Good luck!



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