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ISENTRESS and KIVEXA
Nov 20, 2012

Good morning from Prague, Czech Republic. I am a 43 years old male which has been diagnosed HIV+ in August of 2010. At that time, my VL was 48.000 and CD4 860. Tomorrow, I will start medication and my doctor chose Isentress 400mg combined with Kivexa (600mg abacavirum/300mg lamivudinum). Today my VL is 83.800 and CD4 is 536. I don't drink, don't smoke, don't use drugs and have not been sick since the day I have been diagnosed. Actually, I feel perfectly fit. I am very active profesionally in a stressful white collar position. What is your opinion about the medication combination? Are there known concerns about this combination since I know it is not too commun yet. Many thanks!

Response from Dr. Young

Hello and thanks for posting from lovely Prague.

The combination that your doctor has started you on is one of the "alternate" first-line regimens in current US Treatment Guidelines.

I've quite a bit of experience with the regimen, indeed it was our SHIELD Study of abacavir/lamivudine (Epzicom, Kivexz) with raltegravir (Isentress) that was cited by the guideline committee as support for the listing. Overall, we found the regimen to be very potent and very well tolerated, with very little issues with side effects or toxicity. In our clinic, many patients have now been on the regimen for over 4 years. While not a single tablet regimen, for individuals who can take a twice-daily regimen, the regimen performance has been excellent.

So, while not the most commonly prescribed regimen, I subscribe to the philosophy that for any individual, individual health and lifestyle concerns might make either a "preferred" or "alternative" regimen be a first choice.

I hope that the medication start goes well for you, and please feel free to write back with any feedback about your experiences that you can share with others.

Be well, BY



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