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Isentress
Nov 20, 2007

So...I'm curious. I am newly positive. I had seroconversion illness about three months ago. I don't know what the next six months will look like and what the future has in store for meds but I'm trying to look ahead. From the research Ive done Isentress sounds pretty good. I realize there's no way to know the long term effects but it seems there's much less chance of lipo/strong toxic changes to one's system. However, it seems you have to mix it with other drugs that do cause more side effects. Also, I'm not sure: Is Isentress going to be designated to those who are resistant to other meds only or can treatment naive people start their regimen with it? I guess when I saw that this new class of drug was approved I had a moment of feeling really hopeful because I thought maybe it was a step up from Atripla?(though Atripla has been really good to a lot of people). So I'm just wondering how Isentress is going to be used and how signifigant it is as a new addition to the drug arsenal.

Finally, If it's not too complicated...What is the difference between NNRTI's and NRTI's? Is there a difference?

I will ask my dr eventually as well but sometimes there just isn't enough time to get all the info I would like from him and he does have a lot of patients as I'm sure you do too.

If this is too much of a question...then I won't hold my breath for an answer. I check the forums everyday like the news and I appreciate all the information that I get from it. It's actually really helping me through this. Thank you.

Response from Dr. Wohl

Isentress (raltegravir) is a new drug in a new class of meds called integrase inhibitors. It is an exciting agent and does offer hope for many living with HIV. For now the drug is being prescribed to people who are treatment experienced. This is the setting in which Isentress has been studied. There will be powerful studies looking at Isentress earlier in the treatment cycle.

I would not start on Isentress were I just diagnosed. We know nothing yet about its longer term metabolic profile and nil about body shape effects. There are excellent, well known and understood medication combinations that you can rely on rather than the shiny bright new thing. Atripla is just one.

Both NRTIs and NNRTIs work by messing with the reverse transcriptase enzyme, a protein made by the virus that converts its genetic info from RNA to DNA, the gene language used by our cells. If this enzyme is taken out, HIV can not do its dirty work in our cells. NRTIs mimic the building blocks of DNA but when added to the DNA chain the virus is making, it gunks up the works and stops the process. NNRTIs work a different way. They attach to the enzyme and force it to change shape so it can not work.

I'd recommend you not be hesitant about talking with your doc. He is busy but he should have time to answer your questions. Write your questions down and bring them with you to clinic. You may not be able to cover all but you and he can tackle the most important ones and save the others for next time. Its his job.

DW



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