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resistance to meds. / liver and kidney test bad
Mar 29, 2007

my girlfreind has known for two years she has aids. her # were 88,000 load, 112 cd4the doctors started her meds on viracept/ travada several mounts later, her load wouldn't go down, they switched her meds. to rayataz, travada, noriver. few mounts later, her load started to drop, still not enough,they gave her a resistance test, it showed her to be resistance to 70% of all meds, so she has been switching meds.from one to another, all along the dr. saying she almost out of choices on what she can take an tolerate+ that works. shes been undetectable for 4 to 6 mounts now. now the problem is her her kidney / liver tests are real high, so now they have stoped all her meds. for 2 to 3 weeks. and retest her liver and kidney. she was on travada/kaletra they wont test some bone teest thingie. cause she don't have cancer. so question is this,is there new meds. out there that works and can be given out thats not fda aproved yet other than fuzzieon you know the shots.ones that she can tolerate , and not mess up her insides . what do you seguest? thankyou

Response from Dr. Sherer

Yes, there are still options for new drugs that may be available to her through her doctor. She should talk to him or her about the suggestions that follow.

First, if she has been undetectable for 4-6 months, that is good, and she may not need to change ART. I would suggest that you talk to her doctor about this. I hear that the problem now is kidney and liver complications, which could be unrelated to her medications, or could require a switch due to toxicity. You did not mention whether she also has hepatitis C or underlying kidney disease, so it is not possible for me to help untangle these questions; you will need to do this with her doctor.

To answer your question, if she did need to switch her drugs due to resistance, this is a good era for such a change, because of several promising drugs that are just becoming available for people with limited treatment options. Talk to your doctor about this list:

1) tipranavir: This was the first PI to be recently approved and to have activity against virus that is resistant to all current PIs. It is FDA approved.

2) darunavir: This is another PI with activity against highly PI resistant virus. It is FDA approved.

3) etravirine: This is the first second line NNRTI that has been shown to have activity against virus that is resistant to Sustiva. It is available by expanded access to patients with limited treatment options and heavy drug resistance.

4) miraviroc: This is the first entry inhibitor that can be taken in pill form, and it can be used with enfurvitide (Fuzeon) and other salvage agents. It will soon be available by expanded access to patients with limited treatment options and heavy drug resistance.

5) reltegravir (formerly known as MK-0518): This is the first integrase inhibitor, and it is taken in pill form twice daily. It will soon be available by expanded access to patients with limited treatment options and heavy drug resistance.

Again, your girl friend may be able to take some of these medications, depending on the cause and outcome of her liver and kidney problems. Talk to her doctor about these issues and these suggestions.


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