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Crix to Trizivir

Apr 21, 2001

Hi Doc. I was diagnosed in June of 2000. After wrestling with managed care, by September I finally got my bloodwork and started treatment. Initially I had cd4 at 111 and Vl > 300,000. Initial treatment was combivir/viramune which was stopped after 2 weeks due to fever and rash. Next was Combivir/crix with norvir boost. That was just plain horrid! Finally we settled on combivir and crix. Last bloodwork showed VL of 298 and CD4 of 376. BUT....I got kidney stones. Three in a week! So as of yesterday, I am off crixivan AND combivir and onto Trizivir. Aside from the pamphlet scaring the bejeezus out of me, I am now concerned that I did perhaps a 1 drug switch. What do you think?

Response from Dr. Boyle

I share your concern, especially in view of your high baseline viral load, your history of combivir therapy and your viral load being greater than 50 copies/mL prior to the switch. At this point, to ensure adequate drug therapy and durability of the regimen, I would consider adding on Sustiva (an allergic reaction to Viramune doesn't predict a problem with Sustiva) or another PI (such as Kaletra).

Excessive blood draws?
Once a day the best?

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