combivir sustiva to atripla
May 9, 2010
I have been on combivir and sustiva for 6yrs.Cd4 654 and vl 78.I switched to Atripla 7days ago so far no problems.Do you think my vl of 78 is ok for the switch or should I have been ud for this to be a safe change.My vl for the past few years has been about 60 -80 sometimes ud.I was on azt since 1989,3tc was added in 1996 and ustiva in 2004.Since switching I have a bad case of buyers remorse.I hope I have not made a mistake!And certainly hope I am not going to experience drug failure!Thank you
Response from Dr. McGowan
Thanks for your post.
It is true that most switches are made when the viral load is fully supppressed. Your history of adding meds on one at a time is also unusual in that you have maintain a fairly low viral load for several years. If the level of virus in you blood tends to run low you may have success with combos that normally would not suppress a person with higher viral loads. Certainly the Atripla should work at least as well as the combivir and sustiva since 2 of the 3 medicines in Atripla are essentially the same as in your old combo and the third (tenofovir) usually works well in people with AZT resistant virus (AZT is also part of combivir). If the switch does not fully suppress teh virus you still have other options (protease inhibitors, integrase inhibitors and probably intelence).
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