Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date. I have heard that taking Viread and Ziagen together can (will?) cause an increased VL[viral load]. I have been on Viread since May of 2002, and added Ziagen in June 2003. It is probably important that you know everything I'm on:
Obviously I am already on Salvage Therapy (GOD! I hate that phrase!) For the last 6 to 8 months my VL has been gradually climbing (from 1,600 to 28,000), and my CD4s have been gradually dropping (from 180 to 80). Two years ago my VL was 500,000 and my CD4s were 28. I then gained access to T20 and did a radical change to my meds (including the kitchen sink). While I credit T20 with saving my life, I wonder where I should turn next, as I never hit "undetectable" and fear the direction my numbers are headed in.
Trevor Hawkins, M. D.
Associate Clinical Professor, Dept. Family Practice, University New Mexico
Medical Director, Southwest CARE Center, Santa Fe, NM
The combination of Viread and Ziagen has come under scrutiny because when used with 3TC (Epivir) as the only other drug lots of people had viral load increases. It is thought that this combination makes it easy for the virus to select for resistant species.There may be an interaction between these drugs inside the cell and we are looking at that but no data so far.
In your case, with so many other very powerful drugs in the mix, there should be no problem.
As to where to go next, I think a careful evaluation of your current regimen with a resistance assay (blood test) and some thought given to what is in the pipeline of new drugs will give us the right idea.
The evidence is very strong that even if the virus is resistant to this regimen, the mutations the resistant virus is forced into create a much less aggressive virus so stay on the meds!
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