Can viral load become detachable when switching to Dovato?

[Posbf]

My boyfriend is switching to Dovato from a 3-drug regime (Raltegravir/Emtricitabine/Tenofovir Alafenamide) as he has been very adherent to his medication and been enjoying undetectable viral load for a few years now. Does anyone know if his viral load will spike during the initial transition period when he starts taking the new medication? And should we refrain from unprotected sex? (we practice unprotected oral sex) Any advice is greatly appreciated. Thank you!

[Jim Allen]

Hiya,

Your partner is switching the meds, and the first thing that jumps to my mind is that they are changing drugs within the same class, so it's not like it's a new class of drugs or that resistance should be a concern.

Raltegravir = INSTI (Integrase strand transfer inhibitor) + Emtricitabine/Tenofovir Alafenamide = NRTI (nucleoside reverse transcriptase inhibitor)

Dovato is Dolutegravir = INSTI (Integrase strand transfer inhibitor) + 3TC = NRTI (nucleoside reverse transcriptase inhibitor)

They should not expect any change in the viral load, and I would say the odds of any significant viral rebound are minuscule if they take the meds correctly. My answer might have been more cautious if they had been switching between different classes of meds; In addition, receiving oral sex isn't an HIV risk, and as for giving a blowjob, even without a suppressed viral load, the HIV risk is minute.

Anyhow, end of the day, if you feel unsure/uncomfortable or want to be extra cautious, then play safer until your partner has had their first viral load test post-switching meds to confirm the viral load is still suppressed.

Have you spoken to your boyfriend about your concerns or spoken to their HIV doctor together about this?

[Posbf]

Thanks for your prompt reply! It’s certainly very helpful to know he’s switching within the same class of drugs (I had no idea!) and the risk of viral load rebound is very low. I haven’t exactly told my boyfriend my concerns but have asked him if the doctor had mentioned possibility of viral load changes and he said “no” - which is why I turned to this forum for more information. I will speak to my boyfriend about my concerns and discuss our options. Thanks for all the suggestions, greatly appreciated!

[Jim Allen]

You're welcome.

[Jim Allen]

In my experince, when switching treatments, instead of waiting six months for the regular check-up, they would have me back within 4-6 weeks to ensure everything was alright.

You could ask if that's also the plan when your partner does switch; if so, you will not have to wait long to confirm that the viral load has remained below 200 copies.(undetectable)

[harleymc]

In the bad old days I would be given a blood test every 3 months regardless of switching or not switching medications.  Now days it is 6 month spacing.

[leatherman]

My boyfriend is switching to Dovato from a 3-drug regime (Raltegravir/Emtricitabine/Tenofovir Alafenamide) as he has been very adherent to his medication and been enjoying undetectable viral load for a few years now.

Just wondering why do the switch at all? after 34 yrs of meds, I'm of the mindset if it's not broke don't fix it......unless the newer drug is super-duper better. Just another thought to throw into the mix