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RE What to do - Aptivus

Oct 11, 2005

Doctor, thank you for your speedy response. To answer your question, I am six years poz. Treatment naive. Last VL's over the past year ranging 250 to now 158. About 8% each time CD4 to CD8. I know I have these NNRTI mutations (especially re Viread) but the phenotype and virtual phenotype show sensitivity. Can it be that the Viread can be effective? I'd like to start on 3TC, Viread (or another eg Ziagen) and Sustiva and save T20, Aptivus/rt for later. The pharmactist in my doctors office is pushing me to take T20, Aptivus, Sustiva, 3TC, Ziagen, AZT. I guess my main question to you is what the significance of the TAMs are if the drug is showing on phenotype as "sensitive". What would you do? Thanks. Mike

Response from Dr. Pierone

It is quite unusual, but not unheard of, to have so many resistance mutations in someone who is nave to treatment. But based on the resistance test from your previous post it is very likely that you would respond to a combination of Viread, 3TC, and Sustiva despite the mutations noted. The TAMs in question 41, 210 can affect sensitivity to Viread, but when present in 3 or more (you have 2, the T215S does not count). This would be a much simpler choice than an Aptivus-based regimen. Hope that this help and best of luck!

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