. . . 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
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
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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