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future options
Jun 14, 2010

hi again using atripla or Raltegravir+Truvada in first line regime is bothering me.if start with atripla what will be my second and third line options?? and if i start with raltegravir than what will be second and third line regime given that sooner or later we do develope resistance..... thanks

Response from Dr. McGowan

Most people can keep their HIV suppressed indefinitely if they do not miss doses of their meds. As long as HIV cannot copy itself (replicate), it cannot mutate and cannot escape from treatment. The key is to have an undetectable viral load at each visit. The way to achieve that is taking meds every day to keep the lid on the virus.

Options for Atripla breakthrough wouold include treatments with Boosted protease inhibitors, Combinations of Protease inhibitors with integrase inhibitors, CCR5 antagonsits (depending on the "tropism" of the virus), and the "second line" NNRTIs such as etravirine...you would have quite a few options.

Likelwise if your virus broke through truvada isentress. you still have the boosted protease inhibitors, NNRTIs and the CCR5 antagonists (again depending on "tropism" testing).

The best is to plan for success, but there are options if things do not work.

Best, Joe



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