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switching meds too often?

Oct 25, 2009

My partner has been on HIV therapy after an original diagnosis at CD level 44 for just over a year. He is now at 250 with an undetectable vl. In that time, he has been on three different combos. The first included Sustiva, which he stopped due to the dreams. After that was a combo of Combivir and Kaletra, which was stopped due to uncontrollable diarrhea. He is now on a combo of Videx, Lamivudine, and Reyataz (400 mg). They took him off the combivir so he could take all of his meds at one time each day. We live in a country that has decent health care, but doesn't have much experience treating HIV.

My questions are regarding both the frequency of medicine change as well as his current regimen. Will changing meds so often take away opportunities for treatment in the future? Regarding his current cocktail, is it a decent combo and can he stay on his path of improvement?

Thanks for helping us. We do not have support like this where we live and appreciate the help tremendously.

Response from Dr. Young

Hello and thanks for your post.

It's perfectly ok to switch medications to avoid toxicities, side effects or to improve the convenience (and adherence) of medications. His current regimen is not a very conventional one here in the US, but I can see no reason why it would not be a potent and well tolerated once-daily regimen. (Just make sure that he takes his medications with food, as this is important for the effectiveness of Reyataz).

The only reason why one might restrict future options (or to return to previous medications) is the emergence of drug resistance- so provided that your partner hasn't had evidence of treatment failure because of virologic reasons, he should retain all previous options. To this point, his undetectable viral load and increased CD4 count are very highly reassuring and a good thing to see.

Best of health to both of you, and thanks for posting.


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