Oct 13, 2012
Hello Doctors I am in Australia, and was diagnosed on 9 June this year. My VL is only 8088 and my CD4 count is 637. In conjunction with my Doctor, we are discussing treatment options. We had agreed on (these are the Australian names) Kivexa and Isentress. Today, he mentioned another option which is a once a day tablet, which in the US I believe is called Complera. I have always said no to the other once a day tablet - Atripla - because of the false positive tests it can give to marijuana. I work in heavy industry and am randomly selected for alcohol and other drugs testing. What is your opinion of Complera?
Response from Dr. Young
Hi and thanks for posting.
Perhaps an easy way to look at your two regimens would be to list their pros and cons.
Kivexa (Epzicom)/Isentress Pros: DHHS alternative listing, lacks tenofovir (no kidney or bone toxicity), excellent lipid profile, rapid viral load decrease. Very well tolerated. No diet restriction Cons: Twice daily, 3 pills daily. ?decreased potency of Kivexa (compared with Truvada); requires genetic testing (HLA B5701)
Complera Pros: DHHS alternative listing; one pill, once daily. Generally well tolerated. Cons: Less effective in patients with high viral loads (>100,000). Potential for kidney or bone toxicity; must be taken with a full meal
In the end, there's no single best regimen for all people, but rather a best regimen for each individual person. With your low viral load, Complera is a viable option, but you should be mindful of the need to take it with a full meal and possible side effect profile. If these issues are a problem and taking a twice daily regimen is acceptable, then the Kivexa/Isentress regimen would also be a very good option.
Hope that helps. BY
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