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efavirenz resistance

Jan 30, 2010

Hi Doc

Lab tests just resulted in low level resistance to efavirenz. I am currently on truvada and efavirenz. My Doc wants to change to truvada and reyataz. I am concerned about the side effects of reyataz especially the yellowing of eyes and skin. Are there any other options available? What about truvada in combination with maraviroc? Won`t that be a better change/ Some experts also recommend to change both drugs all together to new regimen...

Would be great if you could help.


Response from Dr. McGowan

Sorry to hear about the efavirenz (Sustiva) resistance.

A switch to truvada + reyatazalone would not be a good move. You would also need to take a small (100 mg) dose of Norvir (ritonavir) to balance the regimen. Tenofovir, which is part of Truvada, can lower the amount of Reyataz in the blood and could make it less effective, ritonavir will counter that.

Truvada + maraviroc might not be enough especially if your virus also picked up any resistance to truvada, which can happen fast. That might effect a treatment like maraviroc more than a protease + ritonavir regimen such as the Reyataz. Also you would need to have your virus tested to be sure maraviroc would work, and that combo would require twice a day dosing. Maraviroc + a combination with a "boosted" PI (that means with ritonavir) might be an option.

If the yellow eyes might be a deal buster you could try a combo of Truvada + Norvir (again) + Prezista which could also be once a day.

Talk about the options with your doc.


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