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.
The participation of Dr. Joseph McGowan in this
Forum is made possible by Boehringer Ingelheim.
|
|
 |
|
Scared of changing
Jun 7, 2006
I have been on a combination of Viramune and Combivir. The last 3 results have shown that my vl is rising, doubling in the latest test to over 12000. As a results my doctor wants to put me on a new combination of KAletra,AZT and Videx. I am afraid of the side effects , especially fat loss. Do you think this is the right combination?
|
 |
|
 |
|
Response from Dr. Daar
Thank you for the post. At this point it would be appropriate to perform resistance testing on your current regimen. I would expect that you will have resistance to Viramune, lamivudine (part of Combivir), or both. Based upon these results switching to new nucleoside reverse transcriptase inhibitors (NRTIs) along with a ritonavir-boosted protease inhibitor, such as Kaletra (lopinavir/ritonavir) would be an appropriate option. The decision as to which NRTIs to use will in part be based upon resistance testing.
Once viable options are selected based upon resistance testing consideration can be given to the risks of fat loss. While there is still much to learn, most data suggest that this problem is most closely linked to use of stavudine (D4T) and to a lesser extent zidovudine (AZT), the latter being part of your current regimen. Drugs that appear to be less likely to be associated with fat loss are abacavir (Ziagen) and tenofovir (Viread). Less is known about other NRTIs such as ddI (Videx). Based upon the available data choices can be made with regards to the risks of developing this problem and the need for select drugs. It is important for you to also know that there may be other causes of fat loss and there are no guarantees that it will never occur regardless of which medications you receive. In addition, there is data that if it develops and you switch off of select medications the fat loss may be at least in part reversible.
Best,
Eric
|
|
|
 Please remember that this forum is designed for educational purposes only, and experts are not engaged through this
forum in rendering legal or medical advice or professional services. Experts appearing on this page are independent and are solely responsible
for editing and fact-checking their material. Neither The Body nor any sponsor is the publisher or speaker of posted visitors' questions or the experts' material.
Questions and messages posted to this forum are not statements of advice, opinion, or information of The Body, Body Health Resources Corporation or any sponsor of this
forum. While neither The Body nor Body Health Resources Corporation regularly reviews posted content, we reserve the right to delete, move, or
edit postings if we deem it appropriate under the circumstances. Visitors submitting questions remain solely responsible for the content of their
messages.
Information provided by experts is general only and should not be used for diagnosing or treating a health problem or a disease, or relied upon as
legal or other professional advice. This information is not a substitute for professional advice or care. If you have or suspect you may have a
health or legal problem, you should consult your own health care provider or your attorney.
Copyright notice.
|
|
|
|
