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Regimen Change?
Jul 22, 2006

As with many long-term survivors (diagnosed in 1991 with 89t's and VL of 1.3mil), I have been on many different individual and combination therapies over the years. I am currently on Lexiva - Trizivir - Norvir and have been for over four years. VL hovers between 15,000 and 25,000 and t's are +/- 300 with % at 16. Phenotype mutations: NRTI - M41L,E44E/D,D67G,K70R,L74V,V118I,M184V,T215F,K219Q NNRT - A98G pi - L10I,K20R,M46L,I54M,L63P,A71T,V82A,L90M.

I am seen by two different HIV specialists who have two very different ideas; one being to continue the current regimen that has worked OK so far with no OI's or major complications, the other view is to attempt to become undetectable with the following regimen; Kaletra (200/50) BID, Truvada once daily and Fuzeon 90mg SC BID. While i recognize the benefits of being non-detectable, it is a goal that I gave up on some time ago and have been happy to remain stable and in relatively good health with the exception of the usual fatigue, gastro-intestinal issues etc. I am hoping to get an additional opinion or two to help with what I perceive to be a potentially life altering (both good and bad) regimen change. Thanks in advance for your assistance.

Response from Dr. Pierone

Well, my vote is with HIV specialist number one who wants to continue the present regimen in light of your stable CD4 lymphocyte counts and viral load.

It makes more sense to sit tight and wait for some of the very promising new agents to become available. With TMC-114 just released you already have a better option than Kaletra and if you can hold out for TMC-125 and/or an integrase inhibitor you may be able to skip T20 altogether. The twice daily shots and welts that they produce is a major negative of this agent. Fuzeon is a potentially life-saving agent, but you can wait at this juncture. Good luck!



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