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Atripla resistance
Oct 21, 2010

I just received my first genotype testing and I am resistant to Atripla (I've been diagnosed for 22 years and I've been on Atripla for the last 3 years). Are there any other regimens that would allow me to take pills once a day? THANKS

Response from Dr. Young

Hello and thanks for your post.

I'm a little unclear by your post. Is your viral load detectable currently? Or is it undetectable?

Assuming that it is detectable and demonstrates resistance to the medications in Atripla (tenofovir/FTC and efavirenz), a switch to an alternative regimen is definitely in order. Depending on the specifics of your resistance profile, it might be possible to construct a once-daily, second-line regimen with a boosted protease inhibitor (such as darunavir (Prezista), atazanavir (Reyataz), fosamprenavir (Lexiva) or lopinavir (Kaletra) with another once-daily nuke combo (such as abacavir/3TC (Epzicom)). Raltegravir (Isentress) is a great option for second-line regimens with a boosted PI, but is currently approved for twice-daily dosing. That said, many doctors do prescribe this once-daily, in light of emerging evidence that suggests that this is acceptable (but not yet FDA-approved).

However, before switching to a new regimen, it's important to introspectively evaluate (and deal with) the reasons why you have drug resistance now- it is because of transmitted resistance or because of suboptimal pill taking. Lastly, I'll say that one should be sure to strive to get maximum potency from the next regimen, rather than only focusing on dosing frequency.

I hope this helps, and best of health to you, BY



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