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Jul 20, 2011

Hello Doc, As per your last advice I went to see my HIV doctor. For more information my recent test shows my cd4 is 265, vl 35k and cd% 15.7%. I have got resistance to emtricitabine and lanivudine it was done in 2009 May. As you had mentioned I could have some other infection but my doctor doesn't think I could have some other infection even though my CD4 fell from 525 in October 2010 to 265 July 2011. I want some advise here. My doctor suggest me to start medication right away and I am prescribed âVIROTRENZ". Major content of the medication is âEFAVIRANZâ. I told my doctor about my resistance but he suggested I should go ahead right now and see how it reacts. Here also I am looking for your advice whether I should go for this medication. Please guide me.

Response from Dr. Frascino


While I agree you should be started on antiretroviral therapy without further delay, I'm concerned that "virotrenz" appears to be a generic for efavirenz. You definitely should not take this drug as a single agent (monotherapy), as you will very quickly develop resistance to it (and perhaps other non-nucleoside reverse transcriptase inhibitors as well). Is your doctor an HIV specialist? He should know this! If he's not a specialist, you need to establish care with an HIV specialist physician. If he is an HIV specialist and still wants you to take efavirenz as monotherapy, you need to find a more competent HIV doc! Because you are resistant to emtricitabine and lamivudine, one option would be to avoid the nucleosides and construct a regimen including an integrase inhibitor, a non-nucleoside and a protease inhibitor: For instance, Prezista (darunavir), Intelligence (etravirine) and Isentress (raltegravir).

Good luck!

Dr. Bob

Help me Obi Bob Kenobi, you're my only hope...
About to cross 72 hs line for PEP, please help

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