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Jul 14, 2013

I have been on PI combo therapy for 18 years. I have never had a viral rebound. I have been on Crixivan, Viracept and Reyataz with a NRT combo. I am currently using Isentress and Truvada. I have only switched meds for easier dosing or for less side effects. I have started to develop GERD. The PPI's and Isentress cause me to have insomnia and headaches. I am considering changing to Duranavir, Norvir and Truvada for this reason. I concerned about taking the twice daily dosing because of the higher rates of side effects. My lipids are borderline high. Except for a couple of blips of up to 50 while on Viracept, I have had an undetectable viral load for the past 18 years with CD4 count around 400. Do you think it would be advisable for me to take the once daily dosing of Duranavir and Norvir since I have never had a viral rebound? Or should I stop my meds for 4 weeks so my viral load will go up so that my doctor can perform a genotype test?

Response from Dr. Young

Hello and thanks for posting.

Since you never really experienced treatment failure (or drug resistance), you'd be considered on "first-line" treatment. As such, you'd be perfectly ok to use darunavir at the 800 mg (with 100 mg ritonavir) dosing.

Given the strong resistance profile of darunavir, no resistance test is needed.

Hope that helps, BY

Autoimmune disorder & PEP
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