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Reytaz + Truvada?
Jan 19, 2009

Greetings from Poland. I have been on reyataz bosted with ritonavir plus kivexa for last two years. The treatment is very successful for me. My doctor however wants me to replace kivexa with truvada due to possible heart related side effects of abacavir. If I understand correctly, tenofovir interacts with reyataz decreasing its level in blood. My question: is it OK to take 300mg of reyataz boosted with 100mg of ritonavir together with truvada? Many thanks, Ralf

Response from Dr. Young

Hello Ralf and thank you for your post and questions from Poland.

First off, a switch from Epzicom to Truvada, or vice versa should be fine for first-line treatment. The dosing of Truvada with ritonavir-boosted Reyataz as you've listed is correct.

That said, know that in my opinion, the data on that would link abacavir to heart disease risk is circumstantial and not complete enough to prove a causality. Indeed, one of the two large studies that suggest this association only really makes the case when the patient has 5 or more cardiac risk factors (meaning that there may be little or no risk among persons with lesser numbers of risk factors). Furthermore, there are other prospective, randomized studies with thousands of patients in total that suggest that the opposite effect (namely that there isn't an association) might be true.

What to do? If you don't have overt heart disease risk, then there's no need to rush to a decision. If you're tolerating Epzicom very well (as most patients do) or if you're at some risk of kidney disease (the uncommon, but known characteristic toxicity of Truvada), then I would certainly recommend making sure that your other heart risks (smoking, blood pressure, diabetes) are well controlled and stay the course.

I hope this helps,

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