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Treatment switch
Dec 28, 2012

Dear Doctors,thanks again for your great efforts in guiding us!I am 63 y and HIV treated since 1986 with various combos without any bigger problems.My V.L. Is undetectable and 600 T4.My combo since 3 years is Tenofovir/Intelence/Isentress/Kivexa and I have requested a "lighter" treatment e.g. Comblera plus one more. My Doctor propose instead to skip Kivexa and Intelence to " lighten" my treatment. What do you think?Will the treatment be strong enough w/o Kivexa/Intelence or should I insist for Comblrra?Your opinion would be highly appreciated . Wish you all a happy New Year 2013 and thanks for what you have up till now.

Response from Dr. Young

Hello and thanks for posting.

It seems like this somewhat complicated regimen has worked very well for you for a long while, so I'd hate to jeopardize this success without a very careful consideration of the options.

It's difficult for me to provide a detailed answer, since much depends on the pattern of drug resistance that your virus harbors. The regimen that your taking suggests to me that you have a very drug resistant strain. It's also important to recognize all of the potential resistant strains, not just the one on the last drug resistant test.

Understanding your reasons and goals for a "lighter" regimen might help- is it the pill number or dosing frequency that is problematic? Do you have other medical issues that interfere with your current medications (like kidney problems)?

What is key is to find a regimen that has at least three fully active HIV medications, if possible. You're currently taking 5 medications, so if the virus doesn't have resistance to tenofovir, FTC or raltegravir (Isentress), then the regimen that your doctor has proposed would be reasonable.

I hope that helps, BY



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