Medication Choices

[mike2002]

Since my initial diagnosis 3 months ago my ID doctor has had me on Atripla (1 per night) and Kaltera (4 per day) to help deal with the virus and my enlarged lymph nodes.  The medication seems to have done the job, my latest numbers are VL >50 and CD4 of 542.  My doctor is supposed to call me tomorrow to discuss treatment options.

I would like to know some of my options before he calls. - Does anyone know where to find a list that shows typical medication choices for the newly diagnosed?   I have tried to find this myself but am a bit overwhelmed by what I need – Do I need one from each group?  NRTI’s, NNRTI’s, PI’s

Also any suggestions would be great!!!

Thanks

Mike

[newt]

Ahem before I comment the info you seek

DHHS recommendations are summarised here

You can download the original guidelines in PDF format (2.4 Mb) from here

All guidelines for countries in the developed world recommend for initial therapy 2 nukes + EITHER 1 non-nuke OR 1 boosted PI.

For an effective combination you need 3 active drugs from at least 2 classes, so I guess you could do 1 drug from each of the nukes, non-nukes and PIs but this is always more complicated in terms of drug interactions. dosing and side effects ... this approach may be useful sometimes to tackle resistance/allergy.

Atripla on its own fulfils this requirement as it is the 2 nukes tenofovir (brand name Viread) + emtricitabine (Emtriva) and the non-nuke efavirenz (Sustiva) in one tablet. 

Alternatively Kaletra + the 2 nukes mentioned would fulfil this requirement.

Recent studies dismissed the concept of adding extra drugs over the standard 3 (except to overcome resistance) ie outcomes aren't better/quicker.

Hope this helps

- matt

[mike2002]

Thanks This was exactly what I was looking for