February / March 2005
by David Gelman, MD
Two new advisories about HIV-cocktail mixology:
Don’t mix nukes Videx EC and Viread with a non-nuke if your CD4s are under 200 and your viral load is above 100,000. In November, Bristol-Myers Squibb (maker of Videx and non-nuke Sustiva) issued a “Dear Doctor” letter saying studies found the drugs ineffective. But Videx and Viread can be teamed with a protease inhibitor (PI).
Speaking of PIs, Kaletra (lopinavir plus ritonavir) can raise liver enzymes (measures of liver health)—especially in folks with chronic hepatitis B and C. Doc should prescreen Kaletra candidates for hep, then monitor liver enzymes every three months or so while you’re on the med.