Intolerable sides effects
Jan 12, 2005
I am currently on a first time regimen of Kaletra, Epivir and tenofovir. Started Jan. 8, went undetectable, <10, since the end of July . Viral zenith was greater than 1,000,000 and CD4 Nadir 279. Current CD4 is >700 I am leaning towards efavirenz and Truvada for simplicity at week 48,~Dec 9. Any thoughts or caveats would be appreciated. Thanks
Response from Dr. Conway
Basically (if one agrees that the FTC part of the Truvada is equivalent to the Epivir you are taking), you are thinking of a change from Kaletra to efavirenz to simplify your regimen to 2 pills once a day. I like simple (yet effective) things. This type of strategy has been employed quite widely in the past with great success and little or no risk of virologic breakthrough. You need to be aware of the risk of efavirenz side effects, including neuro-psychiatric problems (such as anxiety, irritability or bad dreams) or, to a lesser extent, skin rashes or hepatic problems. This are more likley not to occur but if they do, you can always go back to protease inhibitors (including something like Reyataz, as simpler than Kaletra), as you are NOT sacrificing this class of drug by switching away from it while your viral load is undetectable.
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