Question: what is the least toxic HAART combo?
I’ve heard that the NNRT/NRTI combo is better than the PI
is that true for first line combo?
I want the least toxic long term combo.
Also want the least side effects long term.
I’m staying away from Sustiva because of the psychological effects.
My. Doc recommends Viramune + Truvada to start.
I’m not resistant to any of the meds.
I’m concerned about the high liver toxicity in Viramune is anyone
taking this?
What about Epivir?
Is there one called Emtriva I can’t seem to find it on the net?
Thanks.
J.T.
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Dear JT:
If you do not have liver or rash problems, Viramune plus Truvada may be Ok for naives, except for men with over 450 CD4 cells or women with over 250 CD4 cells. It is too bad that this combo has not been studied much, believe it or not.
Emtriva and Epivir are pretty friendly drugs. Emtriva is part of Truvada along with Viread.
Another extremely friendly combo is Raltegravir plus Truvada. No Norvir, no nightmares or depression. Just a little bloating for a few weeks for a few patients. No increases in bad cholesterol or triglyecerides either, and probably not a bad regimen when it comes to lipoatrophy. It is NOT part of the guidelines for naives yet, but data looks encouraging.
Atripla is good for most people but some never get over the bad dreams, and some may have long term depression due to sleep problems. One of the active medicines in Atripla, Sustiva, can cause increases in LDL and triglycerides in some people.
Reyataz plus Norvir plus Truvada is also not a bad combo at all. Once a day and no bad lipid problems or CNS related side effects. But some people are very sensitive to Norvir, and some have extreme sensitivity to Reyataz when it comes to increases in bilirubin. Saquinavir plus Norvir plus Truvada seems to be ok on triglicerides and does not increase bilirubin, but can increase LDL. Lexiva plus Norvir plus Truvada may be ok also but not as friendly on lipids, and it may also shut down your options down the road since resistance to Lexiva may impair efficacy of Prezista, a second generation protease inhibotor.
Of course, your doctor is always the best source of information.