Dr Bob. For one, I love the site and particularly your sense of humor. My question to you is on a professional level. I work in a hospital and at the light of the "downgrade" of Combivir, I was thinking that we should change our needlestick PEP nuke part from Combivir to Truvada (+Kaletra for confirmed seropositive source). Unfortunately, I couldn't find any science based literature backing this combo for sexual or needlestick PEP. In theory, I guess it should work the same, right? We have from time to time tolerance problems with Combivir and I would think switching to Truvada might help tolerance and ease of use since once daily. What are your thoughts on that? I would appreciate any input. thank you Stephan

Hi Stephan,

I agree with using Truvada for PEP and I would definitely choose a Truvada-containing regimen over one that contains Combivir. The "Updated U.S. Public Health Service Guidelines for Management of Occupational Exposures to HIV and Recommendations for Post-Exposure Prophylaxis" support this choice. Of course there are many considerations when optimizing a safe and effective PEP regimen, but in general I absolutely agree Truvada wins hands down over Combivir. And there is plenty of scientific literature to back that up.

Dr. Bob