Thinking about switching Truvada for Emtriva and Ziagen

[Patrick]

My creatinine levels have been in the high normal range (1.2) recently, and I am looking to mitigate or avoid entirely any serious long-term effects of taking these HIV medications.  Right now I'm on Truvada and Kaletra.  The viread in the truvada is not particularly kidney friendly, and the lopinavir in kaletra boots the viread levels in my blood.  Good for killing HIV, and bad for long-term kidney health.  So, I went to the drugs portion of this website and did some reading.  Seems like the alternative to Truvada is Epzicom.  However, part of Epzicom is Epivir, which is associated with peripheral neuropathy, anemia, hairloss etc.....I'd prefer to avoid that as well.

So, I figured, let's take the part of Truvada that doesn't seem to cause major problems (Emtriva) and the part of Epzicom that doesn't seem to cause major problems (Ziagen) and use both of those as the backbone NRTIs for my combination therapy.  I know Ziagen causes a severe allergic reaction in some people, and I'm getting a blood test to see if I'm vulnerable to that in a few weeks.  Barring that, does anyone have an opinion on switching Truvada for Emtriva and Ziagen?  I don't mind that fact that it'll be three pills instead of one.  Small price to pay for long-term health.

Thanks everyone.

[pozattitude]

Patrick,

I took Ziagen and Kaletra for the past 7 years and the side effect of that combo is the increase in your lipids (Kaletra) and the Ziagen (abacavir) is now said to be linked to heart desease.  In my case, with a family history of heart attacks, I am changing my regime to Truvada plus something else (not sure what yet...lol)


Rich

[newt]

Serum creatinine is not a sensitive marker for kidney function. Creatinine is affected by so many things, eating meat, exercise etc etc.

You need a measured glomerular filtration rate (GFR). GFR is the definitive assessment of kidney function.

Calculated creatinine clearance is often used as an alternative to GFR. The value is worked out from age, weight, gender, sometimes ethnicity and serum creatinine. But I personally would want it measured proper like.

For reference a normal creatinine clearance is 100 mL/minute.

The pros and cons here are possible effect on kidneys from tenofovir in Truvada vs. possible increased risk of heart attack from abacavir. A baseline cardiovascular risk assessment may help you decide.

- matt