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Is this a good combo to start?

Jan 2, 2008

My Dr. has recommended viramune and truvada. Because of my concerns with the psychological effects of sustiva he recommended viramune and truvada. Is this as effective as the once a day pill and a good choice for first timers who have never been on meds before? Thanks.

Response from Dr. Young

Thanks for your post.

The regimen that your doctor has recommended is viewed by national and international treatment guidelines as an alternative one (compared to other "preferred" or recommended regimens). Certainly, nevirapine (Viramune) shouldn't be initiated by persons with higher CD4 counts (>250 for women, >400 for men) because of increased risk of serious liver toxicity; there are unsettled questions about the relative potency of nevirapine compared with efavirenz (Sustiva) or any of the boosted protease inhibitors recommended by guidelines (atazanavir, fosamprenavir or lopinavir).

Conservatively speaking, I generally have not been starting patients on nevirapine, but rather have in large part initiated my patients on the once-daily ritonavir (Novir) boosted PIs, mostly fosamprenavir (Lexiva) and atazanavir (Reyataz).

Hope this helps, BY

Feel like crap
Happy New Year!

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