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Starting treatment
Aug 12, 2012

Hello I am soon to start treatment. My last cd4 count was 554 and VL was about 10,000. My Doctor has recommended Kivexa and Nevirapine. I have done the HLA-B*5701 test and all is OK for me to take these drugs. Is this a preferred or recommended combination? No one I know who is HIV+ is on either of these drugs.

Response from Dr. Young

Hello and thanks for posting.

I have a mixed opinion about your proposed regimen. With a negative HLA test, Kivexa (we call it Epzicom here) is a very reasonable option. Kivexa is part of the recommended first line NRTI options in the July 2012 IAS-USA Treatment Guidelines and used commonly in many places. On the other hand, nevirapine is an acceptable option, but should be avoided in persons (like you) with normal-range CD4 cell counts, because of an increased risk of developing a serious liver toxicity.

I'd suggest asking your doctor about the choices in your regimen and why the nevirapine was selected over other more recommended first-line components to pair with the NRTIs (Kivexa), like efavirenz, boosted protease inhibitor or integrase inhibitor.

I hope that helps, BY



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