my new doc wants me to switch meds - should I?

[SouthSam7]

Over a year ago I was diagnosed and immediately put on Truvada, Norvir and Invirase.  Recently I've started going to a bigger clinic in another city.  The first time I saw my new team they all were perplexed as to why I am on the above meds and "does taking all those pill bother you?" etcetera.

They all are hinting that they want to change my meds to something more current (I suspect they want to lose the Invirase and possibly the Norvir).  I have heard horror stories about becoming resistant, etc, when you switch and I want to keep my options open for the future.  My numbers are very good and have been consistent.

Should I resist?  Why do they care what I'm taking if it's working?  The clinic is part of an hiv research facility so I'm concerned they just want me to switch to see what happens.  I'm not sure what to tell them on my next visit. 

They keep telling me I don't need to take pills twice a day but if it doesn't bother me why do they want me to switch? 

I need your opinions because I've only taken my current regimen and I have no experience with changing meds.  What should I do?  Thanks!

Love,
Sam

[newt]

There's nothing wrong with your combo.

You coulld change an reduce the number of tabs you're taking perhaps.  There are several 1 x day combos now. It's a matter of preference.  Some people do better adherence wise 2 x day. Some 1 x day.  If your viral load is undetectable, side effects not a problem & you're happy with the drug routine, there's no real reason to switch.

- matt

[suzieque]

     Hi Sam,
        I am surprised that they want you to change given that you have good viral control, and the meds you are on are not highly indicated in side effects, plus you do not seem to be having any of the effects that you might be concerned about on these medications. What do they want to change you to? Is it anything to do with liver or kidney function, fats etc? If you decide you do want to change, I have had no problem with resistance having changed several times. My understanding is that as long as your viral load is undetectable this should not be an issue. If you are concerned, and it is available to you, perhaps you could ask for a resistance test so they can see if there is anything you are resistant to before changing. I suspect there will be nothing. It is possible that there is something new that they feel is better. My docs opinion is that everyone wants to go for the 'shiny new meds', yet there is not too much known about what side effects they may have yet. Only time will tell. I would find out what they are thinking, why it would be better for you in their opinion, and if you are not REALLY convinced then I would probably take the 'if it ain't broke then don't fix it ' approach. Best wishes with it and let us know what you find out, decide. I would be really interested.
                             All the best,
                                  Suzie

[way.out.west]

Sam, I suspect the doctors are looking at your present regimen from 2 perspectives: (1) even though it might be working for you, it’s not the one of the best combinations as recommended by the DHHS, and (2) other drug combinations with a lower pill burden are available.

Here’s a link to the currently recommended drug combinations http://www.aidsmeds.com/articles/WhenToStart_4759.shtml.  Check out the comments on invirase that appear throughout the page.  It seems to me that by raising questions, the doc are looking out for your well-being and trying to make you aware of the situation.  Ultimately, it will you be your decision on whether to switch.  But before you decide, you might want to do some research and ask questions about the new meds they are recommending.  Here's another link that might be helpful. http://www.thebody.com/treat/antivir.html

I believe that if you don’t yet have resistance to any of the drugs in your present regimen, you can still use them in the future, should you decide to switch now.

[randym431]

I think this is becoming more and more common. I've heard of doctors wanting their patients, on the older meds, to switch regardless of their labs. One big reason seems to be cutting down the number of pills to a more simple regiment. One or two pills a day as opposed to several times a day and several pills. I think they just want to make it easier and less intrusive on their patients.
I'm on the newer meds, but if I wasn’t I would probably switch. The big question is, in the next 3 - 5 years there will no doubt be even better meds with less sides and better performing as well as limiting the danger of resistance. So the big question, will us folks on the newer meds be convinced to switch to even better?