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).
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