Medication change/choice

Question

Dear Doc. I want to ask, what are the principals in choosing/changing medication in the experienced patient (non naive). i understand that the doctor need to take into account many parameters (resistance profile, side effects, diseases etc...) but...Is there some drug family that a physician must include in the regimen? for example, an effective regimen must include a NRTI or NRRTI? there is "non important" drug family? please explain.... Thank you very much!

Answer

Hello and thanks for posting.

All currently recommended regimens include two NRTIs (nukes) and a 3rd drug. The third drugs recommended are either a non-nuke (NNRTI), protease inhibitor or integrase inhibitor.

In some cases, people with extensively drug resistant HIV may have regimens that depart from this paradigm, but this is the exception rather than the rule.

Hope that helps, BY