In Thailand on Combivir + Kaletra. Should be Truvada?
Jun 5, 2013
Because of the M184V mutation that's reportedly common in Thailand I'm concerned about Combivir as opposed to Truvada. From what I understand, Truvada is more effective with the M184V mutation, but the hospital I went to didn't have Truvada. I'm now in a different area of the country and need to go to the hospital to get the 2,3,4 weeks of treatment (1st hospital only gave one week PEP).
I had sex with a women several times unprotected. The next day we went to get her tested and she came back positive at 2 different clinics. PEP was started 15 hours after first unprotected contact. I've been on the meds (Combivir + Kaletra) for 3 days now.
So I guess my question is...Should I try to switch over to Truvada? Especially seeing that the M184V mutation is frequently found in Thailand? Or is my thinking flawed... IOW - Is the M184V mutation not a factor when it comes to PEP?
Response from Dr. Young
Hello and thanks for posting.
Either Combivir or Truvada are acceptable as components of PEP. The M184V mutation affects both combo medications similarly, as the mutation diminishes the activity of 3TC or FTC (respectively) and simultaneously appears to increase the activity of the partner medication (AZT or tenofovir). BTW, 184V is a commonly reported HIV mutation, in Thailand and around the world.
In either case, if you're also taking Kaletra, the overall potency of the PEP regimen shouldn't be significantly altered.
Hope that helps, BY
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