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Phenosense assay shows Zerit on border - Higher Dosage?
Feb 23, 2002

Greetings Dr. Little,

I have a client who recently had a PhenoSense GT assay and showed that Zerit had a fold change of 1.8, just barely over the 1.7 RS cutoff. He had read somewhere that an off-label, higher dose of Zerit can be tolerated and further may be more useful in this circumstance. He is unwilling, at this time, to go on a PI regimen. Can you help? (He also shows resistance to all of the NNRTI's.)

Best Regards,

Jason Gray Topeka AIDS Project

Response from Dr. Little

I do not think that there is currently sufficient data to support the use of higher dose d4T in patients with probable drug resistance. So - if you have phenotypic resistance, I think you are left with new drugs - or continued use of a suboptimal drug - but probably not useless drug. I would be very concerned about the toxicity of an increased dosage of d4T as well.

Driven mutations
New meds for resistant virus

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