Jun 6, 2001
Hi Dr. Little. Thanks for taking the time to answer questions.
The virus I contracted is completely resistant to Sustiva, about 50 resistant to protease inhibitors, and some spotty resistance to nucleosides. A regime of Sustiva, Crixivan, 3TC & D4T got me to undetectable, but after a couple of months I had minor blips above 50 and then hit 300 after 18 months. I was very adherent.
After a phenotype on my original blood sample, I dropped Sustiva and added Ritonavir. Now I come in around 50 (70 to <50). Given these results, when is it time to give the protease inhibitors a break? Should I just stay on them until the virus becomes completely resistant to the boost I'm getting from ritonavir?
Response from Dr. Little
If you became infected with a virus resistant to sustiva, then I think your best options are the protease inhibitors with nucleosides (such as 3TC and d4T). The best choice of which protease inhibitor(s) and nucleosides should be used would require that I know your exact resistance test results. In general though, for people with multiple protease inhibitor resistance mutations, I tend to favor the use of Kaletra (lopinavir/ritonavir) rather than any single PI. There are other ritonavir/PI combinations which may work as well as Kaletra, but without knowing your test results, I cannot advise. I do think that if you have significant protease inhibitor resistance, you should consider one of these ritonavir-boosted regimens - which means taking a low dose of ritonavir with another protease inhibitor (Kaletra contains this in a coformulation) rather than any single protease inhibitor. I think it is even more important to follow someone with your resistance profile very closely, since you may not have the non-nucleosides (such as sustiva and nevirapine) to fall back on. I would want to see your viral load less than 50!
safe sexual activity
HAART halt and resumption
- Shingles After Deep Kissing Worried I Have HIV
- Sore On Penis After Rubbing Vagina Worried I Have HIV
- Swollen Glands After Swallowing Cum Worried I Have HIV
- Swollen Glands After Touching Stripper Worried I Have HIV
- White Tongue After Receiving Oral Sex Worried I Have HIV
- Can You Get Genital Warts When Giving Oral Sex?
This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.
Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither TheBody.com nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.