Apr 24, 2012
hi doc, how complera is more likely to select MDR HIV? if ever developed, what would be the next regimen to replace? is there any cheaper generic version of complera (like viraday for atripla)? regards.
Response from Dr. Young
Hi and thanks for posting.
It's not really clear what the basic mechanism that determines the genetic pattern of drug resistance is or why one drug regimen differs from another of the same classes. MDR HIV is selected after failure of many first-line regimens, but especially those that contain the popularly prescribed and recommended NRTI + NNRTI combo, such as Atripla or Complera. What has been observed in a large head-to-head study of these two single tablet regimens is that upon treatment failure, the Complera patients were more likely to harbor multidrug resistant virus.
Given the large number of current treatments, a second-line regimen after a Complera failure should be readily suppressed, but perhaps with a more complex drug regimen (but what wouldn't be more complex than 1 pill/day?)
Given that rilpivirine, the NNRTI in Complera was just FDA approved, there's no chance of a generic version of this (or Complera) anytime in the near future.
Hope that helps, BY
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