February / March #110 : Warning Signs - by David Gelman, MD

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February / March 2005

Warning Signs

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.




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