|My MD suggests dropping PI
Jul 31, 2001
My Doctor suggests dropping use of PI's due to a recent upsurge in my viral load (8,000). He suggests that a combination of Sustiva, Ziagen and Videx are a very good combination and should work as well as a combination containing a PI.
Do you know of any patients using this combo and, if so, is it effective? Thank You! Derek
Response from Dr. Pavia
I am not sure I can answer the question as to whether it is a great choice for you. I don't know all the other drugs you have been on or what your resistance tests showed. Just as important, I don't know if you have had any problems adhering to the regimen. If you have, it is important to deal with that since you don't get a lot of second chances and you don't want to lose the next combo.
As a rule, it is usually best to change all three drugs when a regimen fails, but it helps to have resistance tests to guide the choice. Sustiva, videx and ziagen are three very potent drugs and can make a very effective combo if matched to the right person. Sustiva should be fully effective even after PI failure, and videx has more limited cross resistance to d4T (zerit), 3TC (epivir), and AZT (retrovir/combivir). If you have high level resistance to AZT or d4T it may compromise the effectiveness of ziagen.
This gives you some idea of the complexity. Hope this info helps you talk things out with your provider.
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