Is Triumeq right for me.....

Question

meqHello Dr. Henry -

Question, does it make "solid" sense to switch my current therapy (Rayataz 200mg x 2 + Epzcom 1 tab) to Triumeq?

History: I'm 45 y/o Male (married with 3 kids) I've been positive for 22 years. I started my 1st and only regimen (listed above) 7 years ago last month. At the time I had a VL of 15K my T-Cells were at 300 (Prior labs never had me with a V-Load over 10K and T-Cells below 300). My VL has been suppressed ever since and my T-Cels today are at 903. BTW - I have also been on Testosterone/Androgel for the past 15 years. No complications whatsoever along the road, I'm healthy and feel good. (I'm not taking any other meds)

At this weeks Doctor Appointment @ Stanford Hospital, my Doc suggested changing my current regimen for Triumeq..... My first thought is "if it ain't broken why fix it". He also suggest I read and pose this question on TheBody.com site.

FYI - I avoided ever switching to Atripla in the past because of its CNS side-effects associated with Sustiva. (I have had anxiety issues most of my adult life along with panic attacks. Ironically there was a dramatic turn for better with my anxiety shortly after starting my current meds, not sure if there is a correlation there or it was just a coincidence, regardless I wanted to throw it out there for you to be aware of and consider.

Back to my question: Does it make "solid" sense to switch my current successful regimen for Triumeg or leave it as is.

I look forward to your reply and any follow-up questions you might have to help me make a solid decision that will benefit me now and long term. Thank you in advance for your reply!!! Best.....

Answer

There is little data on switching to the STR Triumeq from PI or NNRTI based regimens (those studies are underway). The answer depends partly on whether you have any past history of drug resistance (seems unlikely if doing well on unboosted atazanavir + Epzicom). The barrier to resistance for dolutegravir likely would be as high (or as effective) as for atazanavir). Although there is a push for single table regimens I am not convinced that single tablet regimens are clearly better than once a day 2-3 pill regimens. There may be other choices for you besides the Triumeq (Complera and Stribild)-all are reasonable with no head to head data vs Triumeq. I am neutral on the various good choices you may have. KH