It is true - that there are some concerns with some of these meds based on new studies. However - your specific combination is not likely to be effected by the new news. Here are the details.
In two recent studies that started therapy - for those who were treatment "naive" - with a combination of Epivir plus Viread and Ziagen - we've seen a problem. The issue is that for any of a few reasons - this combination just is not potent enough to contain HIV. Now, there are several reasons why this might be the case - and you mention one of the possibilities. Specifically, one of the concerns about the combination using both viread and ziagen together is that perhaps there is some as yet unknown problematic interaction between these two drugs in the cells - and that would cause HIV to escape. Now - your specific combination does contain two of these three drugs - combining Sustiva with viread/ziagen. However - in our studies - when Sustiva has been combined with most any two "nucleoside" antivirals (including ziagen, viread, and several others) we have seen consistent successful viral suppression. As it turns out - we've not seen a study of the specific combination you ask about. However - there is at least for now no info to suggest that just because the studies showed a potency problem when these two drugs were combined with epivir suggests they're always a problem when put together. Meaning - for now - I'd suspect that the reason your combination of viread and ziagen and sustiva is no longer effective has more to do with whatever prior virus resistance you had before you started this combo -- or if this was your first combo - whatever contribution the less than dazzling adherence had to minimize the strength of this combo.
Now - with that T4 count - and that viral load - it is time to see what to do next. Since the HIV related illnesses are a concern when the T4 counts are below 100 - and so perhaps with the help of a resistance test you and your provider might find another combination with more potency and get those T cells back up to higher ground. Perhaps one based on protease inhibitors and perhaps even the newest drug Fuzeon?? There are options - and while I don't know what is right for you I can only urge a review of what the options are for you to get that count back up if you can...
Hope that helps.
And Aloha!
