Advertisement
The Body: The Complete HIV/AIDS Resource
Follow Us Follow Us on Facebook Follow Us on Twitter Download Our App
Professionals >> Visit The Body PROThe Body en Espanol
  Breaking News: FDA Approves Triumeq, New Once-Daily Combination Pill
   
Ask the Experts About

Choosing Your MedsChoosing Your Meds
           
Rollover images to visit our other forums!
Recent AnswersAsk a Question
  
  • Email Email
  • Glossary Glossary


Mega HAART combination?
Sep 13, 2006

Once again I am in the position of a failing combination with my cd4 at 100 and my vl at 750,000...up from 50,000 a month ago. I am a long term survivor (22 years)that is highly resistant to all current meds including tipranavir. My current combo is epivir,viread and t-20. Like others in my position, I am eager to have more than one new drug for my next combo and until the drugs that are in the "pipeline" get to expanded access it looks like my "bridge" will be a mega haart therapy. How does one go about selecting which of the resistant drugs to put together when you have a patient like me that is highly resistant to everything? I have searched for information regarding possible combinations with not much luck. Is the idea behind mega haart to "blast" the virus? Do you look for the best of the worst with my old drugs? Is there any merit to rotating mega haart combinations to really keep the virus guessing? I am very compliant so I am not worried about scheduling etc.. Any thoughts would be greatly appreciated! Thank you in advance!

Jeffrey

Response from Dr. Wohl

HIV meds used to fight multi-drug resistant virus are of two general types: those with activity against the virus and those that will force the virus to maintain mutations that inhibit its ability to replicate.

So, when crafting a regimen for you, the idea would first be to find as many drugs that can be expected to have some activity against the HIV in your body. Darunavir (Prezista) is a new drug that may work even though testing suggests tipranavir won't. TMC125 is a drug in the pipeline but in expanded access now that works against efavirenz/nevirapine-resistant viruses. The Merck integrase inhibitor will soon be available, I suspect, for expanded access, too.

One could look at your genotype and phenotype resistance tests to see if there are any meds from your past that can be recycled - drugs that you do not demonstrate (much) resistance to.

Keeping some AZT and 3TC or FTC on board even though you are resistant to them may help reduce the fitness of your virus by selecting for strains that are mutated and less functional.

DW



Previous
cd4 of 312
Next
HIV positive sister

  
  • Email Email
  • Glossary Glossary

 Get Email Notifications When This Forum Updates or Subscribe With RSS


 
Advertisement



Q&A TERMS OF USE

This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.

Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither TheBody.com nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.

Review our complete terms of use and copyright notice.

Powered by ExpertViewpoint

Advertisement