Hi<\/p>\n
It sounds like efavirenz is not right for you and you have given it a good try. In this case it is easy and best to switch to another drug.<\/p>\n
The guidelines for nevirapine are to not start treatment if your CD4 count is over 250 for women and over 350 for men. If you are a woman, then your doctor is giving you good advice. This would still be ok as an option though if you are a man (I can’t tell from your questions).<\/p>\n
Because efavirenz and Kivexa (abacavir+3TC) are once-daily drugs, one option you have is to use a PI called atazanavir (Reyataz) which is dosed at 300mg once-daily plus a boosting dose of 100mg ritonavir (Norvir).<\/p>\n
This would mean you are still on a once-daily combination, and if this will help with adherence (taking all your pills on time) or with your quality of life, you should discuss this with your doctor.<\/p>\n
Although atazanavir\/r is not strictly recommended for first-time treatment, is is widely prescribed this way in the US and Europe, and a recent study showed comparable results to lopinavir\/r (Kaletra).<\/p>\n
Other boosted PI combinations are twice-daily, and include lopinavir\/r (Kaletra), fosamprenavir\/r (Telzir) and saquinavir\/r (Invirase\/r).<\/p>\n","protected":false},"excerpt":{"rendered":"
I have been taking efavirenz for a month but am going to switch because the CNS side effects are too much.<\/p>\n
My CD4 is quite high – around 360 – so my doctor said I should avoid nevirapine. This suggests I should switch to a PI. Any ideas on which is the best way to go?<\/p>\n
I was taking Kivexa with efavirenz. thanks<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7,10,38,39],"tags":[],"class_list":["post-345","post","type-post","status-publish","format-standard","hentry","category-all-topics","category-changing-treatment","category-side-effects","category-starting-treatment"],"_links":{"self":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts\/345","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/comments?post=345"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts\/345\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/media?parent=345"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/categories?post=345"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/tags?post=345"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}