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What next?
Apr 25, 2007
Dear Dr, I started treatment in 1996( 10 tcell) with 3tc, zerit and crixivan after about a year my doc took me off of crixivan and switched to Viricept stayed on that regiment for 7 years ( never undetectable) viral load around 500 constant cd4's in the 300's
Then in 2003 viral load began to spike and cd4 began to fall , so i was switched to Truvada, sustiva, low dose videx ec and fuzeon, well that did the trick went undectable for almost 3 years , now in 2006 viral load up to 1000 but cd4's remain in the 400's
Reisitance test shows mutations to most PI's and Nrti's ( m184v) no resistance to sustiva.
my doctor is watching test very carefully but i am worried What Next?
Thanks
Ash
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Response from Dr. Daar
Thank you for your posting.
It is great that you have done so well after all of these years. I do share your concerns about planning for the future since if you stay on this regimen with continuously detectable viral loads you will almost certainly develop resistance to sustiva and fuzeon.
Without more details about your treatment history and drug resistance testing I am in no position to make any strong recommendations. However, I would suggest that you talk to your provider about making a change if your viral load is repeatedly detectable. This might be to a regimen that includes one of the new PIs, such as tipranvir or darunavir and possibly with another new agent that has become available in expanded access in US and will likely be approved in the coming months such as a CCR5 antagonist or integrase inhibitors. This is a perfect time to be thinking about the future in order to assure yourself that you will be able to continue to enjoy good health for the decades to come.
Best,
Eric
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