Please Note: Due to volume considerations, not all questions can be answered. Questions most likely to be answered will be those of general interest to a broad group of visitors to this forum. Questions pertaining to a specific case; requests for diagnosis, medical advice, or second opinion; or requests for opinions about untested alternative therapies will generally not be answered.
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Switching from AZT to Tenofovir?
Jun 27, 2007
Thank you for providing this excellent source of HIV info.
I am a 46 yo male, have been taking AZT, 3TC, and Sustiva for 18 months. VL is undetectable, CD4 28% 415, I feel healthy and exercise regularly. No sign of lipo-atrophy either. However blood tests have been showing a bit lower than normal WBC=3.63,RBC=3.87,hemoglobin normal at 15.2, and a bit high MCV=114 and MCH=39.3. My doctor said that since Tenofovir is generally better tolerated, and has no side-effects related to anemia, he thinks I can switch from AZT. My questions are: 1) since this combo has been working very well with little side effects, should I continue until there might be resistance or other problems? 2) I had acute Gout twice in the past, should I be concerned about Tenofovir side-effects on kidney?
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Response from Dr. Daar
Thank you for your post.
The important thing to note is that you are doing great and in all likelihood will continue to do so as long as you take your medications consistently. At this point the decision to make a change is very much a personal one since the current regimen is working and you report to be tolerating it well. With a hemoglobin of 15 you are not anemic and the elevated MCV is expected and not clinically relevant. Assuming your kidney function is otherwise normal I am not sure your history of gout would raise unusual concerns regarding the use of tenofovir.
Sorry I can't give you a more definitive answer but I am not sure there really is one. Whatever you do should be fine as long as you continue to be monitored to assure continued viral suppression and for the development of any side effects.
Best,
Eric
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