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New Once a Day Quad Pill
Aug 1, 2012

Dear Dr. Young: Recently, my Dr. asked me to think about switching from Isentress/Truvada to the once a day Quad Pill. I did well on the first treatment of Atripla except I never got over the sleep disorder (bad dreams..Yikes). However, I'm afraid that the concerns that some doctors are not yet versed in spotting Kidney problems, and the new pill requires the Dr. to be very aware of potential Kidney Problems. Furthermore, some experts have expressed concern that some Dr. have not yet been fully made aware of the shift in thinking and challanges that this new pill can present if not understood by the health provider. I am lucky. I have an excellent Dr. here in Orlando, FL (Orlando Immunology Center) and have no doubt that he is smart enough to understand. I am just concerned that he has not yet had the experience because the Med is so new. Again, he thinks I would be a perfect patient for the pill. What are your thoughts, Concerns and suggestions? My VL is UD, my TCell is 600-700, no problems at all. I look forward to your answer.

Response from Dr. Young

Hello and thanks for posting.

First off, you're receiving your care in one of the top HIV centers in the US-- I'd feel pretty good about the care and monitoring that you're receiving.

The QUAD pill that you're referring to is now in advanced clinical trials and will likely be approved by the US FDA in the weeks to come. Indeed, the OIC group is one of the leading research centers on QUAD and has as much experience as any clinic in the world. Like all regimens that include tenofovir, but also those with the QUAD, monitoring of kidney function is warranted. Since you're already on a tenofovir regimen, the only issue will be to monitor for any changes of your measured kidney function (serum creatinine) after switch.

I hope that helps, BY



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