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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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what meds are right for me?
Dec 7, 2003

I been positive now for 9 years. I'm only been undectectable one time during 9 years of being positive.I try all the meds that the doctor thinks that will get my viral load down and my T cell count up.So far, it's not working. I been on all this meds:


I was on sustiva and combivir for the past year and a half and able to get my viral load undectertable for 6 months I guess,because I went for my next blood work and find out that I'm not undecterable any more. So! She switch from sustiva to Viread and i'm on Viread and Combivir,is still not helping me my tcell now 230 and my Vl 55000,so! She add Ziagen on top of it 4weeks ago. I have develop a bad reaction to the Ziagen,I ran high fever,chill and have had a bad joints pain,that I couldn't take it. She suggested that for me to stop the Ziagen and add the Zerit,but i know what the zerit do to the people that was on it. I told her that i don't want to take the Zerit. My Doctor said that I'm runing out of the options. I'm a mom, to know that I don't have any options. This scares me. For now I'm only on Viread and Combivir.Please I need your advice.

Response from Dr. Conway

I'm sorry to hear about your situation. Most recently, what happened to you is probably a Ziagen reaction, and you should never take this medication again.

As for what you should do, we need to find a regimen that will be easy to take and have a relatively high barrier to resistance. I can think of two types of approaches.

In both cases, you could take a nucleoside combination of Videx-EC and Viread. This totals two pills, and can be taken with or without food because of the interaction between Videx-EC and Viread. What's more, you would need to reduce the dose of Videx-EC to 250 mg/day, also because of the interaction.

The third drug could be Kaletra or boosted Lexiva as a protease inhibitor. Another choice could be to go back to Sustiva but we would need to have a resistance test result avaialble to us on a smaple taken while you were on Sustiva to make sure you do not have resistance to this drug. if this is not available, stick to the protease inhibitor choices.

You will need to watch carefully in the first month of therapy to see if your viral load is going down enough. If not, I would do a genotype on the sample at that point to see what the options are.

I have not mentionned Fuzeon because it seems to me that you may still have other options, but I would keep it in the back of my head.

Good Luck...


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