ART change
Posted: May 28, 2008
QUESTION:
I have a pt. who was on kaletra and epzicom. she stopped it because of diarrhea,and developed PCP. a recent genotype shows the 184. eventually she wants to have more children. CD4 is 184 and VL 50K. She wants a once a day regimen. She does not have GERD or PUD. I was thinking of boosted reyataz with truvada and my colleagues are thinking of boosted reyataz with epzicom and viread. what do you think?
|
 |
|
|
RESPONSE FROM: 
Thanks for your post.
I'd think that a switch to either boosted atazanavir or forsamprenavir would be acceptable once-daily options in place of lopinavir/ritonavir (Kaletra); because of the M184V mutation, tenofovir's potency tends to be increased, so tenofovir/FTC should be a reasonable choice. If a triple NRTI option is preferred, I'll often go with ZDV+tenofovir+FTC (or 3TC)-- this winds up being Combivir+Viread or Truvada +Retrovir.
If children are in the future for your patient, an ZDV-containing regimen will be recommended, though many PMTCT experts will prefer the use of Kaletra in this circumstance. It may be therefore, that using the triple NRTI options that I discussed makes sense.
I hope this helps.
BY
|
 |
|
|
Terms of Use: Please remember that this forum is designed for educational purposes only, and experts are not engaged through this
forum in rendering legal or medical advice or professional services. Experts appearing on this page are independent and are solely responsible
for editing and fact-checking their material. Questions and messages posted to this forum are not statements of advice, opinion, or information of The Body PRO, Body Health Resources Corporation or any sponsor of this
forum.
Visitors submitting questions remain solely responsible for the content of their messages. Information provided by experts is general only and should not be used for diagnosing or treating a health problem or a disease, or relied upon as legal or other professional advice. This information is not a substitute for professional advice or care.
|
|
