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HIV Drug ResistanceHIV Drug Resistance
          
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RESISTANCE
Feb 13, 2004

I HAVE BEEN ON A THREE DRUG COMBO FOR THE PAST THREE YEARS RECENTLY I HAVE BUILT A RESIS TANCE TO EPIVIR ZERIT AND I ALSO TAKE VIRAMUNE WHICH IS FINE MY DIGESTIVE SYSTEM IS VERY SENSITIVE. IAM TRYING TO FIND A NEW EASY THREE DRUG REGIMEN TO TAKE THAT WILL BE TOLERABLE TO MY SYSTEM AND ALSO EASY TO MY BUSY LIFE STYLE.......IN NEED OF ADVICE

Response from Dr. Sherer

The answer to this question lies in your pursuing your remaining options with your doctor. There is no single or simple best answer, not obvious single regimen to start next.

Certainly with D4T and 3TC resistance, there are likely to be options that remain in the NRTI class, and which are simple and relatively well tolerated, e.g. tenofovir, or abacavir.

The most important information to guide this process is the result of a recent genotype and/or phenotype test while you were taking your current regimen.

Then you and your doctor can pick the best next regimen for you. It is important to know if nevirapine, which you have had success with, is still active against your virus.

If so, then perhaps a change of the NRTIs will be sufficient. If not, you are likely to change to the protease inhibitor class. Among these there are several options, including lopinavir/ritonavir, boosted inverase (saquinavir), or atazanavir, each of which can be administered once daily.


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