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Switching cocktails
May 31, 2009

I have become resistant to viracept and truvada. How do I find out about the combo of sustiva, norvir, reyataz and isentress?

Response from Dr. McGowan

Thanks for your question.

The decision about what to switch to will be based on the resistance apttern of your virus. This can be determined through blood tests. For your treatment there are 2 types of resistance tests that would be useful: a genotype or a phenotype. These tests will show how much resistance your virus has developed. Resistance to truvada could cause some level of resistance to most of the medicines in the NRTI class of drugs. Also, if this was not your first treatment, it might be possible that previous resistance mutations from prior therapy would also have to be considered. Resistance to viracept may lead to significant resistance to other protease inhibitors (which include norvir and reyataz).

The key thing is to be sure that your new combinaion has the equivalent of 3 fully active medications (this can be 3 meds or combinations of partly active meds) to keep the virus shut down (undetectable viral load).

If this was your first combo, then resistance testing would help decide if the new cocktail indeed has 3 active drugs.

Best, Joe

HIV strain
I am HIV+ 30 days ago

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