Selzentry taken without tropism test
Jun 23, 2011
I have been taking Selzentry for over a year now, and according to guidelines a tropism test should have been done. My provider said it wasn't necessary and so my question is what is the harm and risk in not first doing a tropism test? Background: I have been undetectable on Trizivir and Sustiva since 2002. We added Selzentry last year, so that I could drop AZT to coutneract lipoatrophy, which I have done this month. Thank you so much!
Response from Dr. Young
Hello and thank you for your post.
HIV viruses are either use CCR5 or the X4 co-receptor to get into CD4+ cells. Maraviroc (SELZENTRY) is the a CCR5 receptor inhibitor. A specialized test is required to see if your virus uses the R5 or X4 receptor. If your virus can use the X4 co-receptor, maraviroc will have no benefit. People with more advanced HIV disease/AIDS or a history of HIV drug resistance are at greater risk of having X4-utilizing virus.
In the past, one needed a blood sample with at least 1000 copies/ml of virus to run the tropism test; now there is an alternative test (called Trofile DNA) that can determine viral tropism from human cells, even if the viral load is undetectable.
With regards to your treatment regimen of AZT, abacavir, 3TC (Trizivir), efavirenz (Sustiva) and maraviroc, a number of simplifications schemes could be entertained. First, since you mentioned dropping AZT, abacavir+3TC (a combination called Epzicom here in the US) and efavirenz would be anticipated to be a very potent regimen (well studied)- and eliminate AZT and maraviroc. A much less studied option (though one that should work) would be to use Epzicom with maraviroc. I would not consider using the later regimen without the tropism test.
I hope that helps. BY
Get Email Notifications When This Forum Updates or Subscribe With RSS
- Sex With A Prostitute Scared I Have HIV
- Flaky Skin After Oral Sex With No Protection Does It Mean I Have HIV
- Tingling Lips After Oral Sex On A Woman What Are The Chances Of HIV
- Can Chlamydia Cause Genital Warts?
- Can The Receiver Of Oral Sex Catch A Std?
- Are Painful Swollen Lymph Nodes In Back Of Head Sign Of HIV?
This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.
Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither TheBody.com nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.