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Sustiva/Combivir Regimen and it's effectiveness
Jan 19, 2005

I have been taking part in a clinical trial that is testing the effecacy of Sustiva/Combivir vs. Sustiva/Truvada, i.e., patients' adherence to either regimen and success in treatment naive patients. I take the Sustiva/Combivir regimen. I have had good success with it. I started in Dec 2003 with a CD4 count of 200, VL 100,000+, 14%. Today, I'm at CD4 of 375, undectable, and 26%. The study goes through Oct 2005. I have missed just two doses (of Combivir) since I started in Dec 2003..99.99% adherent. I am happy with this regimen, but my question is: How long can this regimen last before the virus starts to mutate, given my adherence ability. 5 years? 10 years? I realize these drugs haven't existed that long, but what is the average length of time before failure with someone who adheres to the regimen like I do. My clinical nurse is very happy with my adherence, best in the study. Thank you.

Response from Dr. Sherer

It's most important that you stay as adherence as you have been so far in order to continue to get the benefit of this or any other ART regimen. There is evidence that even the most adherence patients get 'pill fatigue' over time, and may lapse in their record of excellent adherence...so be aware of this trend.

The longest lasting clinical trial of this regimen lasted 5 years, and almost one half of patients maintained good control during that time. It is likely that those who did well, like you, were taking their medications regularly with no or rare missed doses.

Beyond these data, there are anecdotes, and most clinicians know patients who have successfully stayed on a single regimen for longer periods of time than this.

So keep up the good adherence, and regular doctor visits and monitoring, and this type of record is certainly possible.


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