Why AZT/3TC? Plus concerns about drug interactions!

[MalumEnSe]

My partner was recently hospitalized with AIDS diagnosis and multiple OIs (some background here) and just began HIV treatment a few days ago. Initially the hospital ID specialist put him on Sustiva, AZT, and 3TC. We are in Oklahoma, BTW.

I expressed two concerns to the ID, first was that Sustiva would severely lessen the potency of itraconazole which he is taking for histoplasmosis treatment. Second was that 3TC is highly toxic when paired with ganciclovir, which he is being given on IV for CMV. Both of these were kind of brushed off with a "there's nothing to worry about" attitude, but one day after starting treatment, the Sustiva was replaced with Isentress "after thinking about it." Doesn't stir a whole lot of confidence. (Good thing he has insurance and I got a co-pay assistance card for both of those meds, we have to obtain the HIV meds ourselves for them to administer even though he's in the hospital!)

So here are my questions for you fine folks:

• Why would the ID would go with AZT/3TC? Is it because his renal functions are already impaired and a concern and they are safer in that regard compared to, say, Truvada?
• Why put him on the two separate meds instead of just going with Combivir?
• Has anyone here been on Isentress/AZT/3TC?
• Should we continue expressing concern about the 3TC/ganciclovir interaction? What is an alternative to ask her to look into that pairs with AZT/Isentress?
• How do you research to find the best HIV specialist in our area once he is out of the hospital? I hear very good things about specialists at OU.

[eric48]

Tough call

Hoping your bf gets out of hospital soon

Then,of course, this Azt can be revisited

Tenovofir, TDF, might be an option in the (distant) future
In the interim, ABC is a very viable option, but a screen genetic test is highly recommended
The test results take a month to get

So here, not suited for the ER

There is life after AZT... And after HIV... Cheers

[eric48]

Forgot one thing

One user (mickey) takes issentress with 3TC and nothing else

This not standard, but you may want to explore this with a seasonned HIV specialist

[eric48]

How is bf doing?

Are they giving you a date for discharge?

[MalumEnSe]

He got discharged yesterday and is home! Thanks so much for asking, Eric! He's still on Isentress/AZT/3TC, but has a meeting with what will hopefully be his permanent ID doc on the 16th, hopefully she'll run the HLA-B*5701 test and put him on Abacavir/Epzicom. Maybe swap out the Isentress for Trivicay, too. I hate the potential extra toxicity contraindications of him being on AZT along with Valcyte, along with already having anemia issues, but so far he hasn't been having any side effects.

On a side note, my PCP referred me to the same doctor as she's the only one around here that does PrEP prescriptions, so I'm going to be seeing her as well to discuss whether Truvada would be worthwhile for me/us and our situation or not.

[eric48]

Great news!

The case was a bit unusual and exceed the understanding of most of us,here, non doctors

The test comes back OK in 95%, so ...

Had you tried forums with Doctors?