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Switch or leave well enough alone?
Sep 11, 2004

I have been on meds since 1/2004. I am 44 years old. When I started, my viral load was 245,000 and my cd4 was 330 and my cd4% was 9%. I have been on combivir and sustiva. My most recent test at the six month mark was viral load under 50 copies, cd4 486, cd4% 12%. I seem to be tolerating the medicine quite well, with no side effects (with the exception of very slight anemia). Now I hear about the once a day regimens that do not include the AZT which is in combivir. Although I do not have an issue with a twice a day regimen, it really is not that hard to remember, once a day would, of course, be even easier. But my biggest concern is the AZT. I read so much controversy about this particular drug. You hear about all the down side of AZT, and want to know if I should switch. I have spoken to my doctor and he says it is really up to me. Do you have an opinion about combivir versus another once a day treatment without AZT or should I as they say "if it's not broke, don't fix it."

Thank you.

Response from Dr. Conway

I agree with your doctor. In theory, you could switch the AZT to abacavir, tenofovir or didanosine and make your regimen once a day. There are particularly good data on the combination of lamivudine, tenofovir and efavirenz and its efficacy in the long term.

However, all of these regimens, taken once or twice a day, will work extremely well if you take them. If you really feel your life would be improved by taking your pills once a day, then go for it, my friend. If you are just fine now, it ain't broke, so why fix it?

Take care...



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