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Restart Meds after Lactic Acidosis
Jan 19, 2007

I spent nearly 20 years on mostly NNRTIs and my T-cell counts were well maintained. I started a lactic acidosis event. I stopped all meds ( most recently just Combivir). I have regained most of my strength, but my viral load and T-cell count deemed that after 8 months of no retrovirals I needed to start a new regime. My Dr. has added NNRTIs to this regime, is this wise? What are the alternatives to using this class of drugs?

Response from Dr. Henry

Lactic acidosis is most often seen in regimens containing the thymidine nucleoside reverse transcriptase inhibitors (NRTIs not NNRTIs) particularly D4T > AZT. After lactic acidosis oftren NRTIs can be used as a part of an effective regimen but the D4T or AZT is usually replaced by abacavir or tenofovir. I have also avoided NRTIs altogether in some patients using a double boosted PI regimen with reasonable effectiveness. KH

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