Jun 22, 2001
my dr. has proposed a new therapy(kaltetra,fortovase,ddI,and tenofovir). I am resistant to all classes of current drugs. Viral load 30k,t cells 200. Do you feel that this combo has a chance of working. I am also concerned about DDI since I already have severe neuropothy.Is DDI a bad drug?
Response from Dr. Pavia
Without knowing your treatment history and your resistance results, it is hard for me to know if the regimen will work. Tenofovir is likely to be a new drug, Kaletra can be active even with significant PI resistance, and ddI is often still active after several nucleoside mutations occur. I am a bit puzzled by the addition of Fortavase, but I suppose it depends on your genotype and phenotype. In general, it is a bit of a ganble whenever we try and make a salvage regimen for very drug experienced patients.
ddI is not a "bad" drug by any means. It is one of the most potent of all of the nukes. Hoever, neuropathy is more likely to be a problem if you have already had neuropathy.
Since your viral load is 30K and your T cells are pretty good, another option is not to change, but to keep this options in reserve until your T cells start to fall. Perhaps by that time, other options, like T20 will be available. Adding one more class of new drugs is likely to increase the odds of effective control. Hope this helps
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