WHO state combivir plus kaletra as asecond line therapy after failure of truvada plus efavirenz in aresource limited country... I wonder is it ok to use only such combination?
I know that truvada plus efavirenz failure often mediated by mutations to FTC and efavirenz
Doesn't combivir contain 3TC which share the same resistance pattern as FTC????
In aresource limited country there is no resistance testing available so what is the most appropriate combination?
Is it combivir plus kaletra as WHO states????
I will appreciate your detailed response
Boosted protease inhibitors (such as Kaletra) have a high barrier resistance and are usually effective after failure from an efavirenz base regimen in situations as you describe. There often at least modest HIV activity from the Truvada which, when coupled with Kaletra, is usually enough to durably suppress HIV replication to the detection level in situations where lab testing not available. KH