Apr 4, 2013
I am having delays in getting doctors to respond, make appts., etc. to consult on new combination and cross resistance. The curse of not having medical insurance, I guess, but I do need good information until and especially when I do speak with medical providers. So: Planning to start ARV meds after 6-year doctor-recommended holiday with modest resistance. Prior meds were Viramune, Videx, Zerit for ten years. Genotype taken in 2006 showed D67N/K70R/K219Q (NRTI) mutations, V106A (NNRTI) mutation, and "other" RT mutation at R211K. My research indicates low-level NRTI resistance. PS: Recent genotype test came back as wild-type. Proposed regimen is Truvada, Norvir, Prezista. Basically, my question is: are there significant concerns about cross-resistance (esp, NRTI class) with this regimen, and are there any suggestions for what may be a better combination in light of history I have detailed above. Your reply is most appreciated.
| Response from Dr. Young
Hello and thanks for posting.
I like using the free Stanford University HIV DB resistance testing algorithm. If you input your virus' resistance mutations into the program, you find that you have relatively limited resistance: low- or intermediate level resistance to the NRTIs abacavir, AZT, d4T, ddI and tenofovir and to the NNRTIs efavirenz and nevirapine (high level).
With this pattern, it's relatively easy to construct a second-line regimen (I wouldn't call your next regimen "salvage"). I'd have no concerns about the potency of a Truvada (tenofovir+FTC) and ritonavir-boosted Prezista regimen- indeed, this is actually also recommended as a first-line regimen in current US treatment guidelines- testimony to the regimens potency and tolerability.
Hope that helps, BY
Get Email Notifications When This Forum Updates or Subscribe With RSS
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.