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Author Topic: Any Suggestions for New Combo?  (Read 1928 times)

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Offline SirPrize

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Any Suggestions for New Combo?
« on: April 04, 2008, 01:05:38 PM »
Been poz since early 80's but didn't really start "cocktail" til 2000.  At the end of last year I was on Atripla.  My T-Cells began to drop and viral load increased.  Doc performed a Geno/Pheno and unfortunately I had developed the K65R and M184V mutations and the only NRTI options was AZT or Zerit.  From the NNRTI class I had the K103N mutation.  I requested he try me on Reyataz/Norvir and he added Combivir.  At the beginning of this combo my T-Cells were 239.  After 1 month my viral load became undetectable but T-Cells dropped to 198.  Another month passed and my T-Cells went back up to 219/VL undetectable.  The latest labs showed that the T-Cells dropped to 161/VL still undetectable.  I had also developed anemia.  The Doc feels that the AZT portion of the current combo is causing bone marrow suppression and the anemia and wants to get me off the AZT.

He mentioned the possibility of changing my combo to NNRTI- Intelence + PI-Prezista w/Norvir boost + Isentress.  I'm wondering if I would be better off waiting for the new NRTI - Elvucitabine + lower dose ZERIT (20mg) + NNRTI - Intelence?  I took ZERIT from 1996 -2006 before changing to Truvada.  It did cause lipomas and mild lipoatrophy but with the newer guidelines suggesting a lower dose would be as effective plus eliminate the side-effects.  I go for another T-Cell count and VL in May.  Any combo suggestions I can pose to my ID Doc?  Thanks.
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Offline Miss Philicia

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Re: Any Suggestions for New Combo?
« Reply #1 on: April 04, 2008, 01:15:38 PM »
I've not taken Intelence, but I'm on Prezista/Norvir + Isentress (plus Truvada) and it's been a marvelous combination for me.  No side effects really... maybe slight diarrhea from Norvir but it's quite minimal.
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Offline newt

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Re: Any Suggestions for New Combo?
« Reply #2 on: April 04, 2008, 01:42:32 PM »
If you take Prezista/Norvir + Isentress you may only need 1 NRTI, perhaps even just FTC/3TC

I quite like the new NRTI, thought the data is limited.

Zerit at a lower dose is not in the guidelines, it's just in some doc's proof of concept study on 25 people.

Intellence (etravirine) does not interact with Prezista or Isentress. These 3 might be a magic hammer, modern and powerful if unproven. Very stong, resistance, pharmacological and virologically speaking. As a combo it's new -- there's been no study to speak of, but with your mutations, anaemia and falling CD4, if you want to avoid AZT and Zerit, perhaps it's time to ski off-piste a little.

- matt
"The object is to be a well patient, not a good patient"

 


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