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Viracept Effectiveness
Question:
Dear Docs: I've been taking Viracept/D4T/DDI for 7 months with great results...VL undecectable T Cells 1600. My question is, what is the longest study of this combo's effectiveness? I'm real happy with the results but I read in POZ magazine that Viracept may not be as strong as other PI's and that the hype about other PI's working well against Viracept resistant virus was just hype. I was treatment naive before starting and I'm hoping that with total compliance this combo will work for a long time. Also, would it be a good idea to add Hydroxuea to this combo just to give the virus another kick in the butt? What are the side affects of Hydroxuea? Thanks for this forum, this is the best HIV info site on the web!
Response:
Thanks!
I do not agree with the article in POZ. Although Viracept hasn't been around as long as the other PIs, so far the durability looks good. I also don't think we can dismiss the cross-resistance issue as "hype" at this point. In a study that was NOT mentioned in the POZ article but which is the best study of its kind to date, people who had resistance to nelfinavir DID respond to ritonavir/saquinavir. Granted, it was a small study and so far we only have 16 week data, but the results were much better than anything that has been reported to date with indinavir failures.
If you're doing well on Viracept, there's no reason to switch. Total compliance should lead to long-term suppression and success.
I can think of plenty of reasons to add hydroxyurea, but I can't think of any reason not to. The only common side effect is marrow suppression (usually a mild depression of total white blood cell count), which is rarely of any clinical importance.
JG
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