Dr. Holodniy, I previously wrote to you about the tropism test and Maraviroc. I had the test and the results were R5 (as you said they would most likely be). So, Maraviroc is a possible med for me.

I am currently taking Truvada/Isentress but am having side effects most likely attributed to the Tenofovir. So, I may switch to Emtriva/Isentress/Maraviroc (Selzentry). I temporarily went off meds to have the tropism test and have been back on the Truvada/Isentress since 08/10/12.

On 8/29, I had urine tested: Urine Microalbumin = 11.4 Urine Creatinine = 33.9 and the UR ratio was 34 (with 30 being the high end of the standard range. Neither serum albumin or serum creatinine are elevated. All other blood chemistry are normal range.

With the urine readings being as they are is this alone a reason to switch the Tenofovir ?? I am 57: first diagnosed in 11/2011 VL = 46000 CD4 322 Lymph % = 17: I first tried Atripla:severe rash// then tried Epzicom but that didn't work well for me: then the Truvada/Isentress: My current VL is pending but CD4 is 580 and Lymph % = 31.

I would greatly appreciate your comments about the urine tests and the regimen choice. Thanks

The urine tests indicate some kidney involvement, with tenofovir being a possible culprit. Your plan to switch to the combination you outlined is reasonable.