dual therapy
Posted: May 12, 2007
QUESTION:
I have a female patient of 10 years old
She has been treated for 7 years with AZT and 3TC .
She
is well now ,Her CD4 was 20.92% (nov/18/1999),
13.32%(jan,2, 2007)and resistance test shows
resistance
to all NRTIs
1.How can we best balance the risk of TAMs and the
need to switch to second-line regimens? Especially if
we do not have routine access to viral load testing?
2.In what case should we perform suceptibility test
before changing treatment regimen ?
3.Four this specific patient ,what ARVs should we use?
one doctor suggests to treat patient with Tenofovir
because the major mutation to Tenofovir does not
appear yet
Best of wishes
Tran Anh
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RESPONSE FROM: 
I am a bit confused. It sounds like this girl has a good CD4 cell count but, I assume, a high viral load?
You have a recent resistance test that indicates resistance to all NRTIs. Can you list the exact mutations?
Based on this info I can give my opinion as to whether she should swithc therapy yet and, if so, what to. It would also be helpful to know what HIV meds you have available to you.
DW
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