|Prezista/R or Viramune?
Jul 4, 2010
Hi. I've been positive for 9 years and have been fortunate enough to never get an infection even though I've only taken meds the 1st 3 years. Then my CD4s went to 14 and VL 120K. Started boosted Reyetaz/Truvada. After 4 month CD4=128 and VL 1000. Over the next 18 months CD4's didn't move and VL just inched to 358 and stopped. I had lower abdominal pain, sometimes turned yellow, and had a kidney stone(Reyetaz). Frustrated with the side effects and having just leveled off for 2 years after a great 4 month I stopped. I'm not resistant to anything and my VL is 190K and CD4 is 25 so I'm trying to make a commitment to get there and stay there. I started Truvada and Intelence (once daily) 2 weeks ago and overnight had a severe skin reaction that has spread over my entire body. My doctor has stopped everything until we get this under control but I have to decide my next course. I can't do twice daily dosing and I have problems with eating at the exact same time every day. My options are of course Truvad with either boosted Prezista(which I hear is a good drug) as well as Viramune. Which in your opinion would if you just had to guess would I get a better suppression from? Also, is eating a necessity with the boosted PI? And if I may, I have asked for Isentress on 3 occassions now and he just will not go for it. I hear great things and sounds like it can be tolerated once daily. He keeps refering to a possible k104 mutation. Can you explain this or point me somewhere where I can find out more information on the topic and what it means. I've had 2 other specialists recommend it for me that I saw on the side with labs and resistant test in hand. So why is he not like me on Isentress. Thanks for all your help. You guys are great!
| Response from Dr. Holodniy
You are likely to have a great response from either a viramune or prezista containing regimen. However, it your doctor indicated that your virus has a K103N mutation, then viramune would likely be out. In addition, you might be more susceptible to a rash or skin reaction from viramune if that happened to you after intelence. Truvada and insentress is a perfectly reasonable option as well and would be highly effective.
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