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Time for a PI or not ?
Aug 29, 2004

Buongiorno, and thanks for the wonderful job ! I tested positive in 1999, started therapy shortly after, initially vith Videx 400 mg)-Viramune-Zerit. A resistance test done initially was showing no resistance to any drug. In these years I have been doing fine. VL constantly <50, T4 ranging 500-700. In May 2003 in accordance with my doctor we changed therapy in order to reduce lipodistrophy. New therapy is Videx (250mg) Viread and Viramune. At the time a new resistance test was done showing resistance to all NRTI and NNRTI (with exception of Videx and Viread) and no resistance at all to all PI group. Recent lab test are still ok: VL<50 T4 580. Bottom line : I keep having good lab test even tough I am resistant to Viramune. Should I change Viramune with a PI, in this case which would you suggest, considering that Trigliceridi and cholesterol are ok at the moment. Or should I continue with this meds, in such case until when ?? Grazie !

Response from Dr. Holodniy

I need to clarify what you have describe. In May 2003, you stated you had a resistance test showing NRTI and NNRTI resistance. Did you have a detectable viral load and then changed the regimen at that time? Or were you undetectable throughout, in which case, how was a resistance test result obtained? It would be helpful to know what the resistance mutations were on that test. If you are currently have an undetectable viral load, despite some background resistance (if real), I would continue the current regimen.



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