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1st time on meds // epzicom and Isentress please help
Jan 31, 2010

hi

i am a 37 yr male and found out 1 yr 7 months ago i had hiv. my vl around 8k and cd4 count over 450.. so this past october me and my dr's made out minds up for me to start my 1st treatment. witch is epzicom and isentress.. its now january and im am getting my 2nd set of blood work and should be in good shape. my dr said that is this set of test is as good as the rest i can take go to take all meds once a day.. is this a good idea?? also from what i am reading was this a good treatment option to start with? also i have been 100% on top of taking my meds is there any idea how long this treatment will last??

Response from Dr. Young

Hello and thanks for your post.

Your regimen of abacavir/3TC (Epzicom, Kivexa) and raltegravir (Isentress) would be considered an alternate one in current US guidelines-- there are limited clinical trials data on the combo (compared with the more extensively studied tenofovir/FTC (Truvada)+raltegravir one). Truvada+twice-daily Isentress is one of several first-line HIV treatments that are recommended by the most recent US treatment guidelines; if there were reasons why Truvada was not ideal for you or your body (kidney or bone disease are the most typical circumstances), I'd believe the Epzicom/Isentress regimen to be very reasonable.

We are actually conducting a small pilot study of this combination (called SHIELD) of your combination. Preliminary results of the study were presented at last year's European AIDS congress in Germany-- these data are consistent with the larger understanding of raltegravir-based treatments, namely well tolerated and very potent. So far, we have 24 week data on your combination; our study will extend through week 96.

Raltegravir is not FDA-approved for once-daily dosing; I'm hesitant to recommend that patients who don't have a compelling reason to dose once-daily. There is a large ongoing clinical trial that hopefully will resolve this question in the near future.

I hope this is helpful; write back from time to time to share your experiences.

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