Aug 6, 2001
What is your opinion of Trizivir, and would you recommend it as a first defense?
| Response from Dr. Aberg
Trizivir (TZV) is a combination of retrovir (AZT,ZDV), epivir (lamivudine,3TC) and ziagen (abacavir, ABC) in one pill taken twice daily. It cannot be used in patients who have severe kidney disease because the amount of 3TC would be too high for people with kidney disease.
Trizivir is certainly an option for first therapy in some individuals. Other options would be taking a different combination of 3 nucleosides or 2 nucleosides plus a non-nucleoside or 2 nucleosides plus a protease inhibitor. Some physicans may offer a 4 or 5 drug combination in people with advanced disease.
We do not have a lot of data on how durable a response people may get on TZV (meaning how long will people achieve an undetectable HIV viral load). Some experts worry that TZV may not be potent enough for patients with very high viral loads or low CD4 counts. Data is being collected looking at the long term results of TZV compared with protease inhibitor based regimens to see if there is a difference in patients with high viral loads.
TZV is one tablet twice a day which can be of a great benefit to people who have problems taking pills. It is fairly well tolerated. Patients should be cautioned about the potential of having an allergic reaction to abacavir which can be life threatening. You can read more about abacavir on our site.
There is insufficient data on the safety during pregnancy. Some experts have been concerned about the safety of the infant when the mother takes 3 nucleosides. Having said that, I believe a study is in design to address these issues. If TZV is safe during pregnancy, this may be a great option for women in countries that have limited resources for HIV therapy.
I personally have used TZV first line in clinical trial settings and in individuals who I felt this was the best option. It is too early to really say but so far I have had good success with TZV. I base my decision on many factors including underlying illness or symptoms, CD4 count, HIV viral load, HIV genotype, other laboratory abnormalities and patient's ability to adhere to a regimen. The most important factor is the patient's decision and willingness to take their medication everyday. We discuss the pros and cons of each option and together make a decision that is right for that person. You should discuss with your doctor the pros and cons of your options. TZV may or may not be right for you. TZV may also be taken in combination with a non-nucleoside or protease inhibitor(s). So, lots of choices. Choose what is best for you and take your medicines everyday!
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