Question

I'm a man in my late 40s, positive for oner 15 years and in excellent health. My viral load is undetectable and I have low T-Cells that have been on the rise for past eight months. The regimen that I'm on currently is Lexiva, Truvada and I also use Testim 1% gel. I have gained 10lbs of muscle in the past 6 months. I'm currently 188lbs and 5'11''. My question is this, I have a fear of prolonged use of PIs. I've decided with my Doctor to start a new regimen of Truvada and Insentress. That Insentress is a fairly new drug I would appreciate your opinion regarding this combo.

Answer

I have had generally excellent results from long term use of PIs (usually boosted with ritonavir) both from the safety and HIV control standpoints (> 10 years in some cases) so I would say I don't share your fear of long term use of PIs. The role of Isentress (raltegravir) in situations like yours looks promising but actual data (including long term safety and HIV control) is still quite limited. I have been using it is some situations like yours with good results but often the patient had an intolerance to the PIs and some resistance to NNRTU like drugs (ie efavirenz). KH