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HIV treatments
Dec 28, 2009

I have been on HIV treatment since 2002 and currently take nevirapine plus Truvada (tenofovir/FTC). I previously took efavarenz plus Truvada but gave the efavarenz up because of its side effects. My viral load has always been undetectable but my CD4 count won't go above about 390. I am 64 years old and fit and healthy. I was infected in 1993. I am considering options for future treatment and am interested in raltegravir, the new integrease inhibitor. Would that work with nevirapine as a two drug regimen? (I have only recently read that a two drug regimen is often just as effective as the traditional three drugs.) Can the two raltegravir tablets a day be taken together or do they have to be taken at different times of the day? Many thanks, Paul

Response from Mr. Vergel

Paul

I would not try that combination. It has not been studied and you are risking developing resistance to both. The resistance barrier for both Nevirapine and Isentress is not as high as that of protease inhibitors.

A two drug combination that has been studied which is free of Norvir, nucleosides, and non nucleosides is raltegravir (Isentress) plus atazanavir (Reyataz). The data looks good in naives but it is too soon to tell. This combo seems to have very few side effects also.

I would not change what you are taking. Viramune plus Truvada is a lipid and gut friendly combo and I see no point for you to risk developing resistance if your quality of life and immune system are doing OK.

Nelson



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