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Regimen change question
Dec 28, 2007

Due to lack of insurance I was off meds for a couple months. My viral load is 186,000 copies/ml (5.27 logs). Absolute cd4+ 229, absolute cd8+ 771 . A new Doctor is wanting to completly change my regimen. I requested a confirmation set of labs since I have been back on meds for 1.5 months. Doctor insist upon a complete change of regimen wants to put me on protease inhibitors. I am skeptical that such a drastic change is necessary taking Viramune, Epivir,Viread. Any thoughts ?

Response from Dr. Conway

Your doctor is concerned that you developed drug resistance while off the regimen. Due to the Virmaune clearing from your blood much more slowly than the other medications in your regimen, it is possible for resistance to it to have occurred as you were stopping your medication. The two options to consider here are to go to a PI-based regimen to avoid having to consider this OR to go back on your old regimen and watch very carefully over the next 4-8 weeks, to see if your viral load goes down appropriately. if not, then it would be a good idea to change the regimen quickly to make sure that you get back to an undetectable viral load as soon as possible. If this is what you want to do, why don't you see what your doc thinks of this option?



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