HIV, with Dr. Watiti

Mar 14, 2011

UNTIL recently, many people on ARVs in Uganda were using Triomune because it was cheap, and being a fixed dose combination of three drugs (Stavudine, Lamivudine and Nevirapine) in one tablet, taken twice a day, it was easy to adhere to. <br>

Dear Doctor,
My husband who has gone for work in Sudan has been using Triomune 30. We have been buying it at a pharmacy. However, recently when I went to buy the drug for him, I was told they no longer import it. We need to change yet he has been doing very well on it and looking healthy. His CD4 count is over 1000 cells/ml. What should we do because I need to buy the drugs and send them to him urgently?
Regina

Dear Regina,
UNTIL recently, many people on ARVs in Uganda were using Triomune because it was cheap, and being a fixed dose combination of three drugs (Stavudine, Lamivudine and Nevirapine) in one tablet, taken twice a day, it was easy to adhere to.

However, because of its side effects, Stavudine also known as Zerit is now not routinely used in adults in Uganda. Stavudine causes body fat loss or redistribution which disfigures people and can be embarrassing.

This affects people’s self esteem and can be a source of stigma, especially to those who would like to take ARVs and remain anonymous.

It can also lead to nerve damage, making someone feel burning sensations in the extremities, especially of the feet, which is known as peripheral neuropathy.

So even though your husband has not felt anything bad yet, he is better off not using Triomune. There are several options, but usually when substituting drugs it is better if he is seen physically by his doctor instead of being represented because he needs physical examination and laboratory tests before the change.

He can be put on Zidovudine, Lamivudine and Nevirapine or Truvada (Tenofivir plus Emitracitabine) and Nevirapine which could do equally well for him.

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