Dear Dr. Frascino, Thank you so much for all you do. My brother in Africa started Abacavir, Kaletra, and Truvada 2 months ago with CD4 885 and VL 11,000. His Previous combo was DDI,D4t and viread. The thing is he couldn't get Abacavir anymore. He took his last med yesterday. Can he continue his two meds Truvada and Kaletra alone? We are trying to get the Abacavir from Kenya our neighboring country. Will it be okay to start Abacavir as soon as he gets it? we are very worried, Please advice. I can not thank you enough for your time.

Hello,

Without having all the details of your brother's case, such as results of resistance tests, etc., it is difficult for me to give specific recommendations. What I can tell you is that Truvada is really a combination of two medications, tenofovir (Viread) plus emtricitabine (Emtriva). The combination of Truvada plus Kaletra (lopinavir boosted by ritonavir) is considered to be a potent HAART regimen (more potent that your brother's previous regimen of DDI, D4T and Viread). He may not need the 4th drug, abacavir, particularly with his high CD4 count and reasonably low viral load (11,000). I would hold off on restarting abacavir for now, since he's run out anyway, and see what his next CD4 count and viral load are on the Truvada + Kaletra combination. As always, all treatment decisions are best made in consultation with the HIV specialist who is managing the case.

Good luck.

Dr. Bob