Jun 15, 2004
I just started treatment for the first time (no resistance to anything in my genotype) and would like to know if my combination is one that is effective or if I should ask for a different drug combo. I started on Viread, Emtriva and Sustiva, all once a day.
Thanks for your expertise!
Response from Dr. Sherer
There is no single best combination. What is best is a regimen that has the best combination of potency, tolerabilty, convenience, side effects, durability, etc when you are taking it.
That said, the clinical data on your combination is very good on all of the above criteria. In one large clinical trial, about 4 of 5 people on this drug had good responses, with rising CD4 cells and viral loads controlled below detection, for 2 years. Side effects occurred, but led to drug discontinuation in only a small portion of patients, i.e. 5%. The major side effects were neurologic side effects from Sustiva, which occur in half of patients taking it, such as sleepiness, dizziness, vivid dreams or nightmares, and insomnia. Most of these symptoms resolve in most people after 3-4 weeks.
More important, though, than this general information is how you feel on this regimen, whether the side effects (if any) are tolerable and resolve, and whether the once daily dosing is convenient and leads to you not missing a single dose, i.e. maintaining excellent adherence. I urge you to put the same question, and your response to these questions, to your doctor.
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