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Drug regimen change
Nov 14, 2007

I have been on Kaletra/Combivir since 2005 after I developed resistance to first drug regimen. I have been undetectable since regimen change. However, I have developed facial and limb fat loss and the doctor wants to change my medication to Kaletra/Kivexa or Kaletra/Truvada. I have resistance to NNRTIs and also to abacavir, 3TC, d4t, and FTC.My CD4 has been falling over the past six months from 440 to 360. Which regimen would you recommend.

Response from Dr. Henry

In the setting of full viral suppression on Kaletra/Combivir I would expect a switch from Combivir to either Truvada or Kivexa/Epzicom to likely maintain viral suppression. The switch off the AZT (a thymidine analogue) to either tenofovir or abacavir often will slow down and perhaps slowly reverse fat loss from face and limbs. Both choices are fine options. If you have any kidney disease then Kivexa may be preferred. If you are HLA B5701 + then Truvada would be the best choice (abacavir to be avoided in that setting). KH

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