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Geontype results (Old)
Sep 1, 2005

In 2001, I had a genotype done. It showed I had the following Mutations: K103N, V108I, M184V, P225H.

Right now, I am at 950 CD4 and <50 VL -thought the VL went up to 3,00 once-then back to <50.

I'm still on Sustiva and am on Kaletra and Ziagen

I'm a little worries that my Genotype is old, but am afraid of taking a new one despite the great labs. The Doctor hasn't asked for a new one tht I know of (I just get the bloods done and let that be that!)

Am I taking the wrong road?

Many thanks!

Response from Dr. Sherer

Even if your doctor asked for one, the test could not be performed, as most assays require a viral load above 1,000 copies/ml in order to have enough virus to sequence.

Your genotype showed resistance to all NNRTIs including Sustiva, so you might ask your doctor why you are still taking it. I am not aware of any compelling evidence to keep Sustiva in a regimen once this mutation is identified. He or she might want to consider adding a third drug that is likely to have antiviral activity instead of the Sustiva. Choices that come to mind include 3TC, FTC, or tenofovir (TDF).

Also, when Sustiva is used with Kaletra it is recommended that an extra Kaletra tablet be taken twice daily (for a total of 4 pills twice daily). Dropping Sustiva from the regimen would allow you to return to three pills twice daily.

Based on your numbers, you and your physician are not on the wrong road, in spite of my concern above.


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