Magic

[Movingon]

I am very new to this and just have a general question. I saw an interview with Magic Johnson yesterday, which i found to be very good, helpful and somewhat reassuring. He is quiet clearly an advocate of Kaletra - but does anyone know what other drug he takes in his regimen ? The reason i ask is that my doctor is suggesting Kaletra, with Combivir, so i am just trying to decide which to choose.

Many thanks

[trellium]

According to this article in USA Today (dated 12/1/2006), Magic is on Trizivir (AZT + ABC + 3TC) and Kaletra.  http://www.usatoday.com/news/nation/2006-11-30-magic-aids_x.htm

Nowadays most doctors would recommend Truvada or Epzicom (both once daily drug) instead of Combivir.  Combivir (AZT + 3TC) needs to be taken twice daily and has more long-term toxicities due to the AZT component.
If you decide to go with Epzicom (ABC + 3TC), discuss with doc about the B*5701 test for Abacavir (ABC) hypersensitivity.
I'm on Truvada + Kaletra once-daily combo, and so far the side effects are quite minimal after my body got used to it.  The new Kaletra tablet are much more tolerable than the old dreadful capsule formulation.

[newt]

What trellium said << ta for the link to the Magic article.

Magic is perhaps on one too many nukes, unless he has some kind of resistance. There's generally no benefit in taking 3 nukes.

- matt

[megasept]

I am very new to this and just have a general question. I saw an interview with Magic Johnson yesterday, which i found to be very good, helpful and somewhat reassuring. He is quiet clearly an advocate of Kaletra - but does anyone know what other drug he takes in his regimen ? The reason i ask is that my doctor is suggesting Kaletra, with Combivir, so i am just trying to decide which to choose.

Many thanks

Not only an advocate but a paid spokesperson. At the very beginning of his treatment, I actually sent Magic a friendly note suggesting he avoid AZT. He's chosen to promote it, along with other meds.  I wouldn't follow his lead in medical matters.

   -megasept

[Movingon]

The only reason i was "considering" following his lead is that he seems fine 16 years on from Diagnosis. Seems like a pretty good reason to follow his lead to me.

Isn't a kaletra a PI ? so he is on PI, plus Nuke , right ?

Sorry, i am new to this, and i failed science at school !

[vokz]

Chris,

Yes, Kaletra is a boosted protease inhibitor and Trizivir is a triple nuke (effectively your doctor’s suggested Combivir with abacavir added).

You already know my views on what your doctor is suggesting, so I wont rehash them; other than to add that there would be no point in you trying emulate all of Magic’s regimen and taking three nukes.

Print off that i-Base guide I keep sending you (specifically these pages http://www.i-base.info/guides/starting/drugs.html & http://www.i-base.info/guides/starting/which.html). It has all the drugs laid out in an organised manner and explains how the combinations are made up.

Mark

[bmancanfly]

This is terrible news.

Since the vaccine itself didn't give the participants the virus, why would it make them more prone to infection.  It seems to be a very odd outcome.

[bmancanfly]

sorry, the above post is in the wrong thread.

[aztecan]

Print off that i-Base guide I keep sending you (specifically these pages http://www.i-base.info/guides/starting/drugs.html & http://www.i-base.info/guides/starting/which.html). It has all the drugs laid out in an organised manner and explains how the combinations are made up.

Mark

The lists in the links are pretty good and detailed. The only caveat I would include is they  haven't been updated to include the second Fusion Inhibitor or the new Integrase Inhibitor, not that that is really an issue because they wouldn't be used as a first-line regimen anyway.

Chris, just my 2¢ worth, but has your doc done a drug resistance test to determine whether you have any inherent resistance to any of the meds?

I was just curious why he was considering Kaletra/Combivir. They are good drugs, mind you, but the "combo du jour" is Atripla.

From my own point of view, I found Reyataz most agreeable. You might or might not need to boost it with Norvir since this would be the first regimen you would be on. I think the jury is still out on that one.

I have been taking Combivir, or its equivalent (AZT and 3TC) for more than 11 years. It works great, but can cause long-term side effects, as I believe others have already mentioned.

The bottom line is you and your doc need to decide what is best for you. Everyone is different and what works great for me or someone else, including Magic Johnson, may or may not for you.

Let us know what you decide.

HUGS,

Mark

[vokz]

Mark,

You forget that we aren’t all in the US. Chris does not have access to Atripla and the new inhibitors

Mark

[aztecan]

Mark,

You forget that we aren’t all in the US. Chris does not have access to Atripla and the new inhibitors

Mark

Hey Mark,

Oops, my bad. I just assumed since Chris was talking about Magic Johnson he was in the U.S. What they say is true - when you assume, you make an ass of yourself.

I know the E.U. just approved Atripla, but that doesn't mean its available yet. I was just wondering why his doc was recommending the Kaletra/Combivir "cocktail."

HUGS,

Mark

[Movingon]

Hey Chaps

Where i live, it seems Combivir & Kaletra is STILL the reccomended first line treatment, whether you go to a private doc or the gvt.  My doc can get truvada, and i am told he might even be able to get Sustiva , but on a named patient basis. He told me Atripla might be available here sometime next year

I reckon i will push for Kaletra & Truvada, which seems like a compromise to me, and then wait til Atripla comes out and ask to switch to that, by then my head might be stable enough to tolerate the sides i am told can come with sustiva .

Thanks for all yoru input and replies. Its a very tough decision isn't it ?
Cheers

[aztecan]

Hey Chris,

Yes, it certainly can be a tough decision.

Truvada and Kaletra sounds like a good combo to try.

Let us know how it goes.

HUGS,

Mark

[komnaes]

Just specific to Hong Kong -

Aprila I know has already been approved, but I think because of budget constraint (we have close to free universal health care) it has not been offered to all new patients, or just on trial basis. My mother's doctor (also mind) in QE has switched her to Aprila recently.

Shaun

[Paulette]

I had the pleasure of having lunch with Cookie Johnson(magic's wife) last Thursday 11/15/07 in Atlanta and it was to launch the i stand with magic campaign and to promote Kaletra. Which i felt was very wrong, They shouldn't be getting paid to endorse any hiv/aids meds. I suggest that you take your Doctor's advise.
but if you are still interested about magic
you can go to
WWW.ISTANDWITHMAGIC.com
and learn more about his treatment.
i hope this helps.
Paulette

[Inchlingblue]

It's strange that Magic would be taking Trizivir (maybe by this point he isn't?). Not only are there better options out there but the article in USA Today mentions he was on AZT early on (i.e monotherapy), which would indicate nuke resistance, specifically AZT resistance.

Far be it from me to question the wisdom of his ID docs, but Trizivir?  Really???

The fact that he shows no signs of facial lipo is extraordinary. Maybe he's had some PMMA? I know the incidence of lipoatrophy is not as high among African Americans but still.

[newt]

Not everyone on AZT monotherapy got significant resistance and trizivir will work for a fair proportion. Lipo is not automatic, just likely. I know people who's been on AZT and still have a full face (and 1 person on aZT and abacavir with no side effects n undetectable viral load, so there  :P0 - matt

[Inchlingblue]

Not everyone on AZT monotherapy got significant resistance and trizivir will work for a fair proportion. Lipo is not automatic, just likely. I know people who's been on AZT and still have a full face (and 1 person on aZT and abacavir with no side effects n undetectable viral load, so there  :P0 - matt

Newt, all do respect, I don't get your point. Of course not everyone on AZT monotherapy got "significant" resistance or lipo (I should have added the word "likely" in front of "resistance"). I don't have exact numbers as far as those who did get resistance or lipo and I doubt that you do but I suspect a majority of people on AZT monotherapy, out of those who managed to survive it at all, did develop resistance and at least some degree of lipoatrophy.  In hindsight, there's universal agreement that AZT monotherapy was not a good idea.

We can all think of specific, anecdotal examples to make our point and here's mine: I have a friend who has been poz since 1985 and he's doing great, only on his second combo since 1996. He says that the reason he's alive and well today is because he never took AZT. He refused it when it was offered to him, which was brave since it was the only game in town. He decided against AZT because he noticed that everyone he knew who went on AZT got extremely sick and then died soon after starting AZT. That was all the "scientific evidence" he needed in order to know it did not work. We now know that the reason it didn't work was that the doses were too high and it was monotherapy.

So far, the only drug that can sometimes work as monotherapy with some people is Kaletra, which as a boosted PI is technically two drugs, but it's still considered monotherapy for all intents and purposes.

I guess the reason I even posted my comment is that this thread has comments about how money can buy Magic Johnson such excellent healthcare but the fact is that he's on a less-than-optimal combo. But hey, if it works for him, more power to him. There will always be outliers but that doesn't mean that in 2009 Trizivir should be part of anyone's combo if they have access to newer and better alternatives at their disposal.

Since he's a celebrity and appears to be doing so well, it may cause some people to want to go on "what Magic is on" and that would be unfortunate. Not that most competent doctors would agree but you never know, some of the less-than-competent ones might. I'm not suggesting the amount of AZT, as formulated in Trizivir is comparable to what was prescribed in the 80s and early 90s, I'm just saying that when it comes to most people with HIV in the developed world in 2009 there's no reason to take AZT. And it's sad that many people with HIV in the developing world still do have to take it in 2009.

Considering the other part of Magic's combo is Kaletra it would not be far fetched to assume that he's actually on Kaletra monotheraopy which, as you know, is enough to suppress virus with some individuals.

[newt]

Trizivir should be part of anyone's combo if they have access to newer and better alternatives at their disposal

2 reasons:

1. Choice

2. It works quite often, and the "if it ain't broke don't fix it" maxim applies to people on "old" combos, or non-standard combos. The test is does the combo supress the virus to 50 copies or less, not is it up-to-date.

There was a time when Trixivir, or the equivalent looked like an attactive option when set against early PIs and their side effects. At the time it was prescribed it may have looked like a good choce, the best (or least worst) even. Clealy, research moves no and triple nukes are not recommended now.

I have friends from the AZT monotherapy ere; some did it some didn't. I also have ex-friends from that time, who made the same choices. It was not a good time.