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M41L & T215
Nov 5, 2008

My partner has the M41L and T215 mutations and his doctor has put him on Soctin and Kaletra. How robust is this treatment and what is the likely hood of resistance happening?

Response from Dr. Young

Hello and thank you for your post.

The mutations at RT positions 41 and 215 imply that your partner's virus has the potential for significant resistance to some of the NRTI (nuke) medications.

Given this, it's not unreasonable to avoid the class of medications (as your partner's doctor has done) and use a NNRTI+PI regimen. The combination of efavirenz (Sustiva, Stocrin) and lopinavir/ritonavir (Kaletra) has been studied and is generally acceptable with very good long-term potentcy. The key thing for your partner (as it is for all persons with HIV) is to really work towards perfect adherence. This is of extra importance in this circumstance because his virus is already resistance to some key HIV medications- you'd hate to have adherence be the reason why he were to loose the option of other medications.

I hope this helps and wish you both well, BY



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