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Ask the Experts about Strategies for Treatment-Experienced HIVers
I hit hard and early in 2000 at the NIH for about 2 1/2 years. Over the period, I took a variety of meds. AZT, 3TC, D4T, NVP, IDV, EFV, ddI EC, lamivudine, combivir and stavudine (some may be repeats) My cd4 is now down to 385, and my viral load is is the 1500 range. I believe it is time to begin ARVs again. What meds are left for me to choose from?
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Response from Dr. McGowan
Dear Holiday,
Thank you for your contributions at the NIH during the early days of HAART therapy. The answer to your question depends on how much resistance your virus had picked up from the prior treatment. With the use of "boosted" protease inhibitors, and the new generation of protease inhibitors (Darunavir and tipranavir), it is likely that you may have a PI option, also etravirine (a new NNRTI) may be active, the integrase inhibitors will be active and (if your virus tests susceptible on a tropism test) a CCR5 antagonist (maraviroc) may also work. The results of any resistance tests you may have from the past would be very helpful, as well as the viral loads at the time of the switches in your meds. These will help plan your new treatments. You should have a very good chance at finding a successful regimen.
Good luck in '09.
Joe
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Response from Dr. McGowan
