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Tivicay benefits over other medications?

Aug 18, 2013

Hello Dr. Holodniy,

First off, I want to thank you so very much for volunteering at thebody. Your patience in answering every question means more than you will ever know. Also, you have the coolest bowties.

I'm positive you've already heard that the FDA just approved Tivicay (dolutegravir) to treat HIV-1 infection, but I was a bit concerned (being a hypochondriac, of course) about Tivicay's effectiveness in comparison to other integrase strand transfer inhibitors, like raltegravir.

The MedScape article on Tivicay states that the medication, in combination with other antiretroviral medications, "is indicated for HIV-infected adults who have never taken HIV antiretroviral therapy as well as HIV-infected adults who have previously received this therapy, including other integrase strand transfer inhibitors." I know this is a stupid question, but just for clarification, does this mean that those that have already been taking raltegravir cannot ever take Tivicay?

Also, I realize that HIV medication regimens are personalized for each individual infected with HIV and that switching medications wouldn't make sense if a combination already works for you, like raltegravir + tenofovir + emtricitabine combo. However, are there any benefits of taking Tivicay over raltegravir? Are those of us already taking raltegravir "missing out" on anything by not being able to take Tivicay? Or, pardon the expression, should those already taking raltegravir "not fix what ain't broken"?

Any clarification would be greatly appreciated.

Thanks in advance, and I hope you have a great day!

Response from Dr. Holodniy

No, you could switch, but if your CD4 counts are stable and viral load is undetectable, then no, you are not missing out on anything, except for perhaps convenience of once daily dosing with dolutegravir.

Re: How to know if an increase in viral load is a blip or a failure?
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