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What are my options
Feb 26, 2010

I've been hiv + for 29 yrs in june 2010, was diagnoised with PML in 96 and started on meds, viracept and (combiver then trizivir), vl has been undetectable for 10 yrs , cd 4 is up to 525 and 24%, my lipids are above normal levels and my doc wants to change my meds to atripla, will this med help lower my lipids and are there any risks involved with my PML and the CNS nwindj

Response from Dr. McGowan

Glad to hear you are doing so well...you are a true inspiration.

Atripla may be better than viracept for the lipids, although the combo does effect lipids as well. Often the best option is to treat the lipids separately rather than switching.

Certainly the Atripla would be easier to take.

My main concern would be whether or not your virus had developed any resistance to prior therapy that might compromise the Atripla (resistance to combivir or trizivir could lead to cross resistance to 1 or 2 of the medicines inside Atripla). This worries me especially since someone found it necessary to change the combivir to trizivir which may have been done to overcome some resistance that had been found.

Whenever a switch is made the first priority should be not to undermine the main action of the drug...to keep the virus suppressed. That will keep the PML in check because your CD4 will stay up.

Best, Joe



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