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Author Topic: To stop combivir??  (Read 2684 times)

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Offline apple

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To stop combivir??
« on: July 30, 2011, 09:48:43 AM »
Hi,

I am looking for some advice on whether i should stop combivir or not.

I take kaletra, combivir and viread. Have been on this combination for 4 years but my HB has dropped from 14.5 now to  11.3.

I have been advised by my doctor to drop combivir and take tenofovir and kaletra only. I am scared (although i don't like AZT and its effects).

Has anyone out there been on this combination of kaletra and viread only? How did you fair?

Thanks in advance,
Apple

Offline buginme2

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Re: To stop combivir??
« Reply #1 on: July 30, 2011, 10:20:28 AM »
Am I mis-reading you or is your doctor wanting you to go on Kaletra and Tenofovir only?  Wouldn't that be one short of a full regimen?   Why dont you change to Kaletra/Truvada or Kaletra/Epzicom?

Don't be fancy, just get dancey

Offline apple

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Re: To stop combivir??
« Reply #2 on: July 30, 2011, 03:21:43 PM »
Yes, i am being advise to take kaletra and tenofovir only? we do not have a lot of choices from where  come from, however, i am just scared whether i should battle out the side effects of combivir and see my hb reducing or take the risk of dropping it.

Thanks,
Apple

Offline buginme2

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Re: To stop combivir??
« Reply #3 on: July 30, 2011, 10:57:31 PM »
Apple I wish I could offer a suggestion but I just don't know enough about this type of regimen to give an answer.  There are some others on here with more experience, hopefully they will chime in.
Don't be fancy, just get dancey

Offline mikeyb39

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  • Posts: 948
Re: To stop combivir??
« Reply #4 on: July 31, 2011, 08:28:19 AM »
I know i'm a little new to all this stuff, so basically just asking a question.  Why with all the new medications out are doctors still using AZT?  Wasn't that like the worst med with the most amount of side effects?  Try not to beat me up on this, i'm looking to be educated. I would think surely some of the new combos would work
11/02/2010  cd4-251, vl-591000
12/09/2010  started Atripla
02/18/2011  cd4-425, vl-800
06/10/2011  cd4-447, vl-70
10/10/2011  cd4-666, vl-80
01/05/2012  swiched med (prezista,norvir ,isentress, )
02/10/2012  cd4-733, vl-UD  Viread removed
06/10/2012  cd4-614, vl-UD
12/14/2012  cd4-764, vl-UD
09/01/2013  cd4-785, vl-UD
03/06/2014. cd4- 1078, VL-UD
09/05/2014  cd4-850 , VL-UD

Offline Ann

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  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: To stop combivir??
« Reply #5 on: July 31, 2011, 10:19:11 AM »
Apple, although I could not find any documents I could link you to here (they all want subscription money), the majority of hiv meds that are available in the US and other developed nations are also available in the country where you live. (As an admin, I can see where your IP address originates from, but my lips are sealed.)

The possible exceptions are one or two meds from the newer classes (ie Isentress). However, you should have either Truvada or Epivir  available, even if they are only available in their component parts. (See our Treatments page for more information.) These are the meds most often swapped for when one is wanting to get away from the AZT in Combivir.

If you're nervous about only taking two (three if you count the ritonavir in Kaletra) meds (I know I would be), please discuss with your doctor what other options are available. If the availability issue is due to your living in a more rural area, then you may be able to get your local pharmacy, hospital or clinic to bring in the meds you need from a more urban area.

You also have the possibility of buying generics from a company such as Cipla.
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Inchlingblue

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Re: To stop combivir??
« Reply #6 on: July 31, 2011, 11:21:04 AM »
Kaletra is one of the few meds that has worked on it's own (monotherapy) for some people. As Ann mentions, it's actually two drugs but the Norvir is mainly a boosting agent.

It seems to me that the question of whether it will work in your particular case has to do with your resistance profile. I guess in your country they probably did not do resistance testing?

There is currently a clinical trial looking at Kaltera/Viread in treatment-naive patients:

http://clinicaltrials.gov/ct2/show/NCT00679926

Several studies have found Kaletra monotherapy to work, such as this one:

http://www.medscape.com/viewarticle/712633

[If above link does not work you can google: "Lopinavir/Ritonavir Monotherapy Is Noninferior to Standard ART in Confirmatory Study"]


This study was done looking at Lopinavir/ritonavir + tenofovir Dual Therapy versus Lopinavir/ritonavir-Based Triple Therapy:

http://www.omicsonline.org/1948-5964/JAA-02-056.php

You can also ask the doctors at thebody.com:


http://www.thebody.com/Forums/AIDS/Meds/index.html
« Last Edit: July 31, 2011, 02:44:02 PM by Inchlingblue »

Offline Ann

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  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: To stop combivir??
« Reply #7 on: July 31, 2011, 11:54:03 AM »
Inch, Apple comes from a well-advanced country - but I'm not at liberty to say which country, it's not my place to divulge such information. I would imagine that resistance testing is a standard of care where she lives, just like it is in most "westernised" countries.

And thanks for the information regarding Kaletra. I was thinking it was another med that had been looked at in reduced-med regimens and/or monotherapy.
Condoms are a girl's best friend

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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline newt

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  • the one and original newt
Re: To stop combivir??
« Reply #8 on: July 31, 2011, 04:51:05 PM »
You can almost certainly get 3TC, one of the 2 drugs in Combivir. If you swap this for Combivr and keep the rest, you will be ona full 3 drug combo and have dropped AZT, the other drug in Combivir that is probably causing the problems.

- matt
"The object is to be a well patient, not a good patient"

Offline apple

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  • Posts: 36
Re: To stop combivir??
« Reply #9 on: August 01, 2011, 06:38:29 AM »
Thanks guys for your responses. I will follow up on the links provided.

Ann, its true that i am living in a developed country, but i still get all my meds from my country (developing). The  medical insurance here, does not cover such diseases like AIDS for foreigners of my status, (profession) so every few months, i have to organise meds (generic) from home, hence my saying, i do not have many options. Even my lab results have to be interpreted by my doctor at home. The doctor here just facilitates to get the blood samples and handover the results. Interpretation and decisions about the results are done home. (very cumbersome, but unavoidable!)

The meds in my country of residence  are unaffordable without medical insurance. So when the doctor is making decision to switch drugs, it is done based on availability.

I did the resistance test (which was also extremely expensive without a medical insurance) and i am resistant to 3TC and nevirapene so far.

Thanks once again for your comments and advice.
Apple

Offline newt

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  • the one and original newt
Re: To stop combivir??
« Reply #10 on: August 01, 2011, 08:11:22 AM »
Taking 3TC with tenofovir still works even with the resistance. The mutation which usually makes 3TC resistant (called M184V) makes the changed virus more susceptible to tenofovir.

Generic 3TC is really cheap if you can get it.

- matt
"The object is to be a well patient, not a good patient"

Offline Ann

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  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: To stop combivir??
« Reply #11 on: August 01, 2011, 08:42:49 AM »
Wow Apple, that sounds like a real pain in the arse. And I thought I had an inconvenient arrangement in having to fly to Liverpool for my hiv care - that's nothing compared to what you have to do.

Good luck with dropping AZT - chemically induced anemia is no fun. When I was on treatment for hep C, my HB went down to 8.something for a while and it was a struggle to just stand up, never-mind walking up the stairs or even across the room. I had to reduce the dosage of one of my meds and the problem went away in a few weeks. Don't let your HB get that low! I was having trouble too when my HB was 11.something, and the lower it got, the more breathless and weak I became. Hang in there!

Oh, and listen to Newt. He knows his stuff when it comes to hiv treatments. Personally, I trust his advice implicitly. :)
Condoms are a girl's best friend

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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline newt

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  • the one and original newt
Re: To stop combivir??
« Reply #12 on: August 01, 2011, 05:33:37 PM »
Quote
Personally, I trust his advice implicitly

I get things wrong, people should know this, so go CHECK (but in this case I am not making one :-) )

- matt
"The object is to be a well patient, not a good patient"

Offline Ann

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  • Member
  • Posts: 28,140
  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: To stop combivir??
« Reply #13 on: August 02, 2011, 09:04:48 AM »
I get things wrong, people should know this, so go CHECK (but in this case I am not making one :-) )

- matt


Troo 'nuf, but 99 times out of 100 you ARE right. And yes, I do check. ;D
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

 


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