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Changing from Epzicom+Prezista+Norvir to Combivir+Sustiva
Mar 10, 2013

Hi, doctor.

It's me again. I previously posted here about my partner being prescribed with Atripla, Trizivir and Viread by his primary doctor when he was admitted to the hospital. After he was discharged, he was finally able to visit an HIV specialist and corrected his regimen.

Now, he is on Epzicom, Prezista and Norvir. I trust that this is a good combination.

However, maybe within the next two years, he will be moving to another country where these medications are not available. One of the most common combinations in this country is Combivir+Sustiva. I am recommending that he discuss this option with his doctor so that when he moves to another country, his body has already adjusted well and he can just keep taking the same meds.

Is it safe to change to this regimen? And given that he has just changed meds, is it ok to change again soon or does it require months first before he changes to another set of meds again?

Response from Dr. Young

Hello and good to hear back from you.

Good to hear that you're partner is now on a more conventional regimen. The current regimen is one of the current US Department of Health and Human Service Guideline "alternate" ranked ones- and one that we use in our clinic from time to time- particularly among people who have issues with kidney or bone problems.

If a move to a different country is in the distant future, I wouldn't concern myself too much over the possibility of switching. First, two years is a long way off in terms of drug accessibility- it could easily be that by that time additional medications could be available, or that your partner may have switched to a different regimen altogether. Second, it is safe to switch from one to another regimen, provided that there aren't any concerns about the presence of drug resistant HIV (ie., if his baseline tests don't show resistance and he's remained undetectable in viral load testing). Switching doesn't require any particular time on medication- I just obtain viral load tests prior to- and about 1 month after the switch to make sure that these assumptions (and new medications) are correct.

Hope that helps, BY



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