Hi:

I've been positive for 25+ years. Started on NRTIs in the 80's, so I have resitance to them. Now on Kaletra, Rescriptor and Truvada. I had never taken PIs or NNRTIs before this combination and I am undetectable for 6 years. Baseline viral load is 200,000 and 110 CD4s. Do you have any thoughts on how I can drop the NNRTI? I would like to save that class of drugs for the future. Can I combine Kaletra with one of the newer PIs and still keep undetectable?

Thanks for your help.

Scott

Thanks for your post.

The definative answer to your question depends a lot on the type and extent of NRTI resistance that you have.

Based on the general assumption that tenofovir/FTC often retains at least partial activity in virus with previous NRTI resistance and further, that in PI-naive patients, lopinavir/ritonavir (Kaletra) alone (or, perhaps other boosted PIs) can have impressive activity without other ARVs, it isn't unreasonable to consider eliminating delaviradine (Rescriptor) from your current regimen.

Dropping delaviradine should be done with an understanding of the potential risks and benefits to you-- something that you and your doctor should discuss in detail before making any changes.

If I were your doctor and we decided to go this approach, I'd monitor your viral loads very carefully in the weeks-months following discontinuation of the NNRTI.

Hope this helps, BY