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Raltegravir, Etravirine and Truvada based regiment
Apr 8, 2013

Hi Doc, I am currently on boosted Darunavir, Truvada and Etravirine. I have some resistance to the drugs in Truvada but they are still partially active. I have been suppressed with very high CD4+ count (1100 in February) for almost 5 years. I have had very high cholesterol since I started Darunavir and I am not very keen to start statins. Since I also have resistance to Efavirenz, my Doctor suggest that we could try to change the regiment to Raltegravir, Etravirine and Truvada. I was so excited to hear that I will not have to take Norvir any more. However, he said that he needs to do a little research before changing as this regiment is very unusual. What is your opinion about this regiment? do thing it is safe to give it a try? Thanks in advance. H (Norway)

PS: here are my genotypic resistance profile: NRTI: K65R, M184V, T215I. NNRTI: L100I, V179D. I have no resistance to the other classes.

Response from Dr. Young

Hello and thanks for posting from Norway.

Regimens for people with drug resistant virus can often be somewhat unusual, especially if working around issues of side effects, toxicity or other health issues (like high cholesterol or kidney injury).

The basic principle is to try to have at least two and preferably three fully active medications in the regimen- so if your drug resistance tests don't show evidence of resistance to the current medications (ie., no resistance to etravirine, unlikely (though usually not tested) resistance to raltegravir), I'd think the regimen should be ok and safe and have minimal effect on cholesterols.

I hope that helps. Let us know how the switch works for you. BY



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