Managing combivir/sustiva side effects
Mar 28, 2008
I have been taking Combivir and Sustiva for four years. Each time, my Cholesterol is a little higher (still 178, but they were 157 when I started). Of immediate concern: my Trigs are astronomic (712 after 12 mos) Through very careful diet, loads of exercise, I have them down to 330. With a CD4 of over 750, what is the best recourse from here. I am worried about switching to Viramune because of my high CD4 counts. Also, if I switch, should I have a down time? Many thanks!
Response from Dr. Henry
The Combivir can also be contributing to the increased triglycerides (3Gs) so a switch to Truvada (or Epzicom if HLA B5701 negative) might be helpful before further considering a switch from Sustiva ro Viramune (if that switch performed I simply monitor very carefully for liver or skin problems during the first weeks/months---most patients do fine). Many patients have some form of familial 3G problem (? status of other family members) or have some form of metabolic syndrome that can contribute to 3G elevations. Niacin, fish oil, and fibrates used alone or in combinations can often significantly decrease 3G levels. KH
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