I've been taken off of Zerit because of Neurapathy. Have only taken any drugs after early diagnosis a year ago. My original combo was Zerit, Viramune and Epivir. They worked well. Neuropathy caused doctors to consider changes. Just started Videx which came from pharmacist with warning not to take because of association with neuropathy. What percent of patients in studies have each of the following have seen increase in neuropathy symptoms? Videx, AZT, Epivir, and zerit. I was, according to one doctor,going to Viramune plus combivir. Now have been put on Viramune, Abacavir and Videx - I would prefer the former combination because of what I've been able to read about neuropathy. What is your opinion. My viral load was 250 or so last test and my cd 4 was 1350. I had taken a 2 month drug holiday when cd 4's even a little higher and viral load undetectable (in order to see if no zerit helped neuropathy - it didn't) when viral load went up to 31,000 and cd 4's down to 900 I went back on original combo. neuropathy continues to be severe. Two doctors at the clinic I attend disagree - therefore my request for a third opinion.

Thank you so much.

Well - of the nucleosides we use - d4T/zerit, ddI/Videx and ddC/Hivid have the most problem with neuropathy. And in someone who has had neuropathy bad enough to stop one of these meds, we do find that some will find it difficult to take any of these other three for very long. You might do OK however - sometimes ddI has less problems than d4T and some can get away by using it and find the neuropathy does not get worse. Perhaps that is why one clinician suggested it. We also find that if you did get some worsening of the neuropathy on ddI - when we stop it the neuropathy should improve over a few weeks.

The other nucleosides, however, appear to have even less problems with neuropathy. AZT, abacavir and 3tc have the least reported problems with this issue. And the nonnukes - like Viramune - also don't appear to have this problem.

So - should it be AZT/3tc/viramune - or ddI/abacavir/viramune? The answer may not just be a choice about neuropathy - it sounds like one doctor may be concerned about some resistance having happened to the 3TC? If there was any resistance to that med - then azt/3tc/viramune won't work well - but the ddI/abacavir combo would work better. And I can't tell from what you write if that is playing a role in what your doctors are thinking about...

You might ask each why they think their combo is the right one, and why they wouldn't go with the other combo. It may help to clarify what to do.

good luck. CC