Which nukes: Truvada or Kivexa?

Both Truvada and Kivexa combine two nukes in one pill, that can be taken once-daily. They each have benefits and disadvantages.

Truvada = tenofovir + FTC
Kivexa = abacavir + 3TC
Neither tenofovir nor abacavir are linked to lipoatrophy, neuropathy or anaemia.
Abacavir is not recommended in people with a high risk of heart disease and should be used with caution if viral load before treatment is above 100,000 copies/mL.
3TC and FTC are very similar drugs. They are interchangeable if individual nukes are prescribed separately rather than as a combined pill.

Tenofovir is cleared from your body by the kidneys, and monitoring for kidney toxicity, and not using tenofovir with other drugs that are cleared the same way, are important safety cautions.

Tenofovir can cause a small reduction in bone mineral density during the first 6 months, but does not seem to increase any risk of bone disease with longer use.

Abacavir can cause a side-effect called a hypersensitivity reaction that occurs in up to 7% of people.

A genetic test, called HLA B*5701, now used widely in the UK, reduces this risk. A negative result with this test does not guarantee that you will not get this reaction, but makes it much less likely.

Abacavir hypersensitivity reaction

Symptoms of the reaction include fever, rash, headache, sore throat, diarrhoea, abdominal pain, tiredness, nausea, vomiting, flu-like aches etc that get progressively worse each day.
Anyone who gets these symptoms must seek urgent medical advice with a view to stopping the abacavir.
Once stopped, abacavir must not be used by that person again, as a worse reaction can return that is potentially fatal.

This is the web edition of the i-Base guide Introduction to combination therapy. This guide is available in UK clinics. You can order free printed copies or download a PDF version (516 Kb). Translations. Authors and credits. Glossary. Full section index.

Decisions relating to your treatment should always be taken in consultation with your doctor. Information in this guide is intended to support those discussions.