06/10 Starting Viramune (Nevirapine) + Kivexa (Epzicom = 3TC / abacavir)

Meds, Mind, Body & Benefits > Questions About Treatment & Side Effects

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eric48:
08/09 : contamination (age 47)
09/09 : sero conversion
04/10 : tested +
04/10 : CD4: 440 CD4%: 18 CD8%: 61 VL: 65k (4.82 log)
05/10 : CD4: 535 CD4%: 16 CD8%: 63 VL: 52k (4.71 log)
05/10 : CD4: 453 CD4%: 20 CD8%: 55 VL: 68k (4.84 log)
06/10 : Viramune (Nevirapine) + Kivexa (Epzicom)

This regimen is listed in the US as an alternative (rather than preferred) and not for men with CD4 above 400 (and women with CD4 above 250)
In Europe it is in the recommended list with a warning for extra caution for men with CD4 above 400 (and women with CD4 above 250)

I took the HLA B*5701 test, the one that tells you if Abacavir should be avoided. I am negative : I can have it.

My readings are above 400 (440 to 535, depending...) therefore I was not expecting my HIV specialist to come up with this recommendation.

I have a number of concerns because of my age (getting close to 50), my blood sugar (was borderline before infection and now in the frank diabetes zone), low HDL (40 at conversion, now 35)
but no AIDS related events, no confection, I am even CMV neg ! - no enough kissing, I suppose) , no BMI issues (BMI at 22.5), no liver problems, etc. I walk or jog every non-rain day
One concern is brain/neurons issues in my family (Alzheimer, etc.)

Doctor says he likes the fact that one component (I think that is Abacavir) crosses the blood/brain barrier and therefore may have a protective effect

I looked into the available literature that compares various regimens and came to like this regimen better than others (due to my specific concerns).
Actually I like it a lot. For example it may protect the brain while not having the psycho effects of Efavirenz (I should emphasize 'may').
Seems to be a regimen you can stick with for a long time

Genotype says I have only one mutation (T215E) which forbids only AZT and d4T
All other options are open

PI s look a bit scary, not so much that they are, but because it seems to be jungle where the non specialist, like myself, can get lost
Atripla is the king of the block these days and Raltegravir the new kid in town.
Both taken with Tenofovir (not so much of my liking)

My doctor is a long timer HIV specialist who runs a HIV clinic (somewhat specializing in MSM). He has seen a lot...
I asked him about adverse effects such a lipo and he raised his eyes, like he leaves that to odds
The way he is...
He seems to know that if I were asked to choose between damage to my brains or to my face, I would not sacrifice my being myself.
So he does not ask. The way he is...

My doc says this regimen was demoted for adverse reaction concerns but is likely to be promoted back to recommended next year or so.

He likes it, I love it: there is no hesitation here.

Special caution means extra liver markers analysis with my blood work and extra visit to the clinic (every 2 weeks for the first 10 weeks).
The doc is a big guy, very impressive, and very good at handling people's stress and anxiety
The extra visits are a bonus !...

Special caution means that I looked through the internet for people having used the same Viramune/Kivexa combo and did not find many threads

I like the idea that this regimen is a bit off-limits, a challenge custom designed just for me (although I am sure a lot of people have used it before me)

I am a bit concerned though and this is why I would like to hear from others who have used it. Please kindly share your experience with me and others

Many thanks in advance Eric

J.R.E.:
Welcome Eric,

I am on the same regimen, ( Viramune and Epzicom) I've been on this regimen since January of 04. I started meds October of 03, And it's still working for me. I am 58, and started meds just about 18 years into being diagnosed positive. I also was taking Viread in that mix from around August 2004 until October of 09. I dropped the Viread, and everything is still going well.

My numbers were a lot worse than yours when I started. My t-cells were at 16, viral load @ 500,000 and a percentage around 4% ( in October of 2003.) My current percentage is 15% . I am currently waiting on blood test results from June 2nd.

The highest my tcells have been, ( since starting treatment) were the high 380's. I am currently in the low to mid 350's.

Viral load has been undetectable since November of 04 ( you can read this info on my signature at the bottom, And my CBC, Chemical profile , and Amylase , are always within range, However my cholesterol did take a jump up, after starting on meds, and I am on Simvastatin . I also have hypertension, so I am also on BP medication .

I deal with mild to moderate neuropathy, since starting on meds. Although I believe it's more Virus related.

I've never been on Protease Inhibitors. When I started on Viramune, it was a two step process. One viramune tablet a day for 14 days, then two tabs a day after that. I take my viramune at 8:00 AM and 8:00 PM . 12 hours apart. I take the Epzicom with my daytime dose of Viramune.

I get labs approximately every 3 months. It has been this way since I started.

The doc will be checking you liver panel during the first few weeks, just to make sure your tolerating the Viramune well, and will be monitored regularly after that. A small percentage of people can also have a allergic reaction to the Ziagen portion of Epzicom.

Herman ( on this site) is also on the same regimen.

Ray

EDITED FOR CORRECTION OF DATES

J.R.E.:

--- Quote from: eric48 on June 12, 2010, 03:16:30 AM ---

Doctor says he likes the fact that one component (I think that is Abacavir) crosses the blood/brain barrier and therefore may have a protective effect

--- End quote ---

I believe that's Viramune that crosses the blood brain barrier.

Ray

J.R.E.:
Eric,

I am sure you've probably already read this info, but I will post it for you just in case :

VIRAMUNE :

http://www.aidsmeds.com/archive/Viramune_1616.shtml

Epzicom :

http://www.aidsmeds.com/archive/Epzicom_1580.shtml

Ray

J.R.E.:

By the way, your not contaminated !! Your infected with a virus, none of us are contaminated !

Ray

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