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nucleoside options
Oct 25, 2006

You answered a question of mine on 10/18 regarding use of Reyataz. Currently I am on Ziagen, Viread, Reyataz w/Norvir. I developed resistance to Susitiva in 2003 so I believe that family of drugs is no longer an option for me (that is the only drug I am resistant to at this time). In your response (on 10/18) you stated that you do not prescribe Ziagen and Viread together because of the possibility of overlapping resistance pattern. I'm not clear on what that actually means so could you please clarify that for me. I'd also really like to get your recommendations on what you would prescribe as an alternative approach. Thank you very much for your time and information.

Response from Dr. Henry

Generally, if using Viread or Ziagen I would couple with either FTC or 3TC (combinations of Viread + FTC= Truvada and Ziagen + 3TC= Apzicom). There isn't much information on using tenofovir and abacavir together in the absence of 3TC or FTC so I am unsure of the level of added advantage using those drugs together without 3TC or FTC in a boosted PI regimen. If you are already taking abacavir + tenofovir I often would add 3TC and drop the tenofovir (which can decrease the Reyataz levels) and combine the abacavir + 3TC as Epzicom. with the new 300 mg Reyataz tablet the regimen would then be 3 tablets/day (Norvir/Reyataz/Epzicom). I would modify in cases of intolerance to 3TC or FTC. even if you have the M184V mutation conferring some resistance to 3TC or FTC I often wouuld still use 3TC or FTC. KH



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