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Epzicom/Reyataz without Norvir Boost
Dec 18, 2007

Please help! I'm very confused about MED options -- probably cuz there are many choices, which is actually a good thing, right? I have been POZ for about 2.5 years, but just had to start meds 6 months ago. Been on Atripla, which has been successful at providing me with an undetectable viral load and brought my T cells up to 445 from a low of 345. Problem is side effects of extreme fatigue, major headaches, nausea that just won't go away. I've consulted several different docs/ID specialists, etc, and am leaning toward epzicom/reyataz without Norvir boost. I took the HLA-B*5701, and it does not show I will have an alergic reaction. I have a history of family heart disease and have elevated lipids(which I haven taken meds for the past 5-6 years). Plus,I'm worried about lipodystrophy, etc. However, one doc thinks I should start with the Norvir boost, and then stop it if it is too tough for me. He feels this is wise cuz if I ever have to take it later my body may not tolerate it. True? I'm relatively small and weigh only 137 lbs (not underweight), so we're trying to find combinations that may have the lowest side effects. My other choice: doc is having lab check the sustiva levels in my body to see if I can stay on my current regimen with a lower dose of sustiva. Your thoughts on this are appreciated, too. My genotype study shows I'm not resistant to anything. I'm really at wit's end, as I've been dealing with fatigue/headaches/etc for 6 months, but confused about what the "right" choice is. I feel fortunate to have some knowledgable docs in my area, but the different opinions make my choice-making abilities complicated. Please respond soon --- and Thanks for being there for us! Happy Holidays to you and everyone at TheBody.

Response from Dr. Wohl

I am with doc who says try Reyataz, Norvir and Epzicom. You may be surprised at how well this works and it is an easy regimen. If you do not tolerate the Norvir (unlikely at this dose) or get too yellow switch to the higher dose Reyataz and bag the Norvir.

We like using Norvir with Reyataz as it works better at keeping the virus down and also protects against resistance to Reyataz. But, that said, I suspect Epzicom and unboosted Reyataz will work well for you given your commitment. Try it with Norvir first.

DW



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