Treatment Naive and Viramune

[darwin]

Treatment naive means I've never been on treatments before.  But it also means I am totally clueless about treatments!

All of my HIV+ friends and my HIV+ ex are on Sustiva, the wonder drug.  Yet I am strangely drawn to Viramune and its promise of decreased noticeable side effects (plus a free charred liver!)

Does anyone have thoughts on treating naive people like me (*cough*) with Viramune rather than Sustiva?  When I see my doc about this in a couple of weeks, is this even a request he can grant??

Lastly, once on Viramune, can I stay on it for a decade?

[minismom]

I can only tell you about Mini's experience with susteva and viramune.  She was on a lot - and I mean a LOT - of combos prior to Feb. 2002, but her VL wouldn't drop below, i think, 2mill+.  She was put on Susteva on 2/02, after having a genotyping done.  By 6/02 her VL was undetectable.  She stayed on Susteva until 1/08 when we switched her to Viramune to decrease the side-effects.  Unfortunately, she had a reaction on day 11 and we had to stop the Viramune. BUT, we didn't put her back on Susteva or any other "replacement" drug.  She had 2 blood tests done after her reaction just to make sure she was still on the right track.  Now, after her 3rd test this past Monday, I'm happy to say that she's doing wonderfully!  Her cholesterol and Triglycerides are still high, but her VL is still u/d and her t-cells are 1207 (down from 1394). 

In short: Susteva did wonders at getting her VL to u/d.  She does have lypoatrophy, but who's to say that it's Susteva's "fault".  She had a reaction to Viramune, which can happen, but not to everyone.  Some who have a mild reaction can still stay on the drug, she couldn't.  She's been on a 2-drug regiment - Zerit and Kaletra - since 1/08 and is doing WONDERFULLY.

Hope that helped, but I'm sure it just confused you .  The point is, and the lesson I learned is, try it out.  If it doesn't work, there are options.  If it does, then do a happy dance.

mum

[Peter Staley]

darwin -- please read our AIDSmeds lesson called When Should I Start Treatment, and What Should I Take First?. 

The DHHS guidelines on which drugs to start with are explained on this page:
http://www.aidsmeds.com/articles/WhenToStart_4759.shtml

Viramune is listed as an "Alternative" starting option, probably because it has additional side effect issues and less overall data concerning potency over time.  However, I still think it's an option worth considering.  Those who take it that don't experience any of its side effects find it very easy to take (although its TWICE a day dosing is worth noting).  I've been on it for years, and have had no problems with it.

In the actual guidelines, there's a chart that compares the two, with their benefits in the first column, and their possible downsides in the 2nd column.  Please note the CD4 warning regarding Viramune.  I've attached a pic of these two columns below.

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