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? change from Combivir to Kivexa?
Sep 11, 2007

I have been taking AZT + 3TC (either separately or since 1999 as Combivir) since seroconversion in 1996, first with PIs, and since 2001 with Efavirenz. I get great results - VL is consistenly undetectable, and T clees range 700-900. Lipodystrophy is now showing. My HIV expert seeks to me change to Kivexa, predominanty for long term health benefits, and also alleviation of the Lipo. My concern arises from fear - if it ain't broke, why fix it? This is especially so since I so much love being alive. Is my fear/concern unfounded? What do you think?

Response from Dr. Pierone

My friend the writer has a circa 1980 IBM electric typewriter which he still uses. He has this stuff called 'white out' that he uses to cover up his mistakes and type over them. Why hasn't he moved on to computers and word processing? You guessed it, it ain't broke. So my question to you is whether your car still has a carburetor or have you moved on to a model with fuel injection?

More to the point, why aren't you still taking vintage Crixivan to go along with your antique Combivir?

Clearly, in the modern world we take advantage of advancements in technology to improve the quality and (hopefully length) of our life. Fewer pills, fewer side effects, better results sounds like a winner to me.

However, my only argument is with your HIV expert who recommended the switch to Kivexa (Epzicom, Ziagen + Epivir). Ziagen can produce a hypersensitivity reaction (about 7% risk) which can occasionally be severe, although rarely fatal. Truvada (Viread + Emtriva) would be a better choice because it eliminates this risk and also is associated with better lipid effects.

Thanks for posting and let us know what you decide to do. Good luck!

mild neutropenia
Zinc and selenium ok?

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