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How safe is my meds long term
Aug 23, 2017

I have been on truvada and isenntress for nine years should i remain on them or should i change to one pill regimen

Response from Dr. Young

Hello and thanks for posting.

Your regimen is one of very few that are recommended by the august US HIV treatment guidelines.

If you've been doing well 9 years into the this three pill, twice daily dosed regimen, it's hard to imagine that you'll suddenly do better by switching to a single pill. Indeed, in several well-designed clinical trials, twice-daily Isentress with Truvada was actually superior to once-daily protease inhibitor regimens, and in other blinded clinical trials, shown to be comparable to once-daily regimens containing another integrase inhibitor, dolutegravir. If switching to a once-daily regimen offers you convenience, there is a brand new FDA-approved formulation of Isentress (called Isentress HD) that allows you to safely take it once daily (albeit two pills).

As for other potential switches, Truvada has a new updated cousin called Descovy with a better aborbed version of tenofovir (called TAF). TAF has a somewhat better toxicity profile, with lower risk of bone and kidney injury. So if you're at risk of, or have problems with either bone or kidney health, this could be part of your treatment calculus.

There are currently three (and in the near future, four) single tablet HIV regimens that contain integrase inhibitors. All are excellent regimens, but offer only marginal benefit for someone like you who's done well on a contemporary and recommended (if not single pill) regimen.

In the end, it's worth a careful discussion with your provider, weighing the benefits, potential risks (of any new medication) and convenience factors.

I hope that helps, BY

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