Can A Durable Regimen Be Crafted

Nov 2, 2010

My current regimen (Videx EC 400mg, Emtriva 200mg, Reyataz 400mg) has been durable for over 5 years, VL <50, CD4 > 1000. My (new) doctor is insistent that Videx be removed. We have tried Ziagen, that was met with endless days of low grade fever (despite alle testing to the contrary), AZT caused a month long of nausea, and Viread made my hands and face swell. I am panicked, because I'm worried that without these meds, I won't have many options available to me - except the initial one (which I am presently on). I have lost many days of work, and now, some hope. Can a durable HAART regimen be crafted from the remaining drugs available. Resistance testing has not been completed, as my regimen began when my CD4's were 650 and my VL was 36000 (circa 2005). Thank you for your time and consideration of my request.

Mark

Response from Dr. Henry

There are likely many treatment options available to you if you reside in a resource rich region of the world (ie North American, Europe). Often a boosted protease inhibitor with Truvada would be a durable regimen for many patients. Other options would be use of a NNRTI drug like etravirine (if you have chance for NNRTI resistance from prior use of nevirapine or efavirenz). Raltegravir or miraviroc are two other options often useful in the setting of modest resistance. If your viral load has always been undetectable than the chances for resistance are diminished and more options are available to you. HIV specialist are usually quite knowledgeable about switch options once the entire treatment history has been reviewed. KH