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. . . and then what next
Jun 28, 2005

Doctor, given my earlier posting, if the resistance tests results hold and its assumed I'm still good for Sustiva, what do you recommend I do, having lost Viread (and possibly 3TC)? Can I add Viramune to the combo? How about the new protease inhibitor? I suppose T20 is an option too but not crazy about having to inject . . . any advice you could offer would be appreciated. Thanks very much.

Response from Dr. Young

Thanks again-

Based on your resistance tests and the Stanford HIV resistance database, one might predict that your virus is indeed quite resistant to first-line drugs.

The Stanford interpretation of your virus' mutations looks like this:

APV Intermediate resistance ATV High-level resistance IDV High-level resistance LPV High-level resistance NFV High-level resistance RTV High-level resistance SQV High-level resistance

Drug Resistance Interpretation NRTI Resistance Mutations: M41L, V118I, L210W, T215S NNRTI Resistance Mutations: None

RT Other Mutations: 43Q, 211K

Nucleoside RTI 3TC Potential low-level resistance ABC Intermediate resistance AZT Intermediate resistance D4T Intermediate resistance DDI Intermediate resistance FTC Potential low-level resistance TDF Intermediate resistance

These would suggest I would be trying to build a potent regimen around a NNRTI (like efavirenz or nevirapine), perhaps in combination with tipranavir (though drug interactions can be a problem) or T20. In cases like yours, I try to obtain a phenotypic resistance test to provide further clarity about your existing options.

Good luck again, BY



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