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Non treatment naive regimen switch to Truvada/Isentress alone?
Dec 30, 2009

Ok Ok Ok :) I have been positive eighteen years. Last year about this time or a little earlier my Doc switched my meds from Truvada Sustiva and right now I can't remember (its late)to Truvada Isentress Prezista Norvir. BAM! The best labs evah! lol So now and herein lies my question. This month my Doc decides to remove Prezista and Norvir from regimen. I'm stoked at the idea of it. However my feeling is why jump off a winning horse? It took alot of heartache to get those magnificent lab.. Is it common to do this in this day of treatment? To REmove meds while one has perfect results on them? She wants to STreamline my regimen, and says should still have stellar results with just the 2 meds. As WEll cautions lessen as to future long term effects of drugs - all. I've been taking Truvada for 5 years I think. I mean I'm not exactly "treatment naive" ya know! I have so much gratitude for meds and am the most compliant patient btw. Thanks for your answer. Peace out. Kimi A.

Response from Dr. McGowan

Dear Kimi

I am not clear as to why your regimen was changed last year. If your virus was undetectable on Truvada Sustiva (and the change was made because of side effects) than a substitution of a medicine like Isentress or Norvir+ Prezista for the Sustiva should be fine. If the switch was made because of treatment failure (detectable virus on the regimen) than simplifying to just truvada and Isentress may not be a good idea since the Isentress may be left without enough support from the truvada (similar to what happened with the Sustiva) and you may loose control over time.

This kind of strategy: called Induction and Maintenance is more common in Europe than in the United States. The key is not to simplify to a regimen that is not strong enough to keep the virus in check.

Best, Joe



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