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Epzicom - Combivir
Aug 31, 2009

Years ago, I failed on a combination of meds that included Combivir. Then, I went on Ziagen/Viramune/Videx and it worked for me for 10 years. Now, my doctor is recommending Epzicom/Isentress (he wants to get me off Videx to cut down on lipodystrophy and neuropathy).

Question: Since both Combivir and Epzicom contain Epivir, and I failed on Combivir, should I be concerned that I may have a resistance to Epzicom?

Thanks!

Response from Dr. McGowan

Thanks for your question. It may indeed be the case that your virus had picked up a resistance mutation to epivir, it would be the most common mutation on a treatment failure that included combivir. Also, there are some zidovudine (also part of combivir) mutations that could effect ziagen. Videx may retain activity against an epivir resistant virus (although they share some cross resistance too). Isentress works best when it is combined with at least 2 other active drugs. If epivir and partial ziagen resistance is present in your virus the new combo may not meet that mark. You should discuss these matters with your doctor and see if an old resistance test may have been done before the last switch, that may answer some questions.

Best, Joe



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