Resistance to all integrase inhibitors

[texaninnyc87]

A friend of mine just told me that he found out his strain of HIV is resistant to all forms of integrase inhibitors. I dont know why, but he didnt ask his doctor what this meant and is now freaking out. I've tried to do my own research but medical shit still really confuses me. I told him that, based on what I understand, they are just one class of HIV drug. you need a few different kinds of drugs in order to keep the virus under control in a way that it will not mutate to become resistant to, kind of like using hair gel and spray to keep your hair styled. i told him i think this will probably rule out most of the one pill once a day options and will likely mean he will just have to take a few more pills than the average pos person. am i completely off base? what are his options looking like?

[leatherman]

ARV therapy is combination therapy of 3 types of anti HIV medications. Integrase inhibitors are only one type. Currently they are Isentress, Dolutegravir, Elvitegravir (as listed on the AM DRUGS page). These are "newer" meds and so PIs, NRTIs, and NNRTIs should all be available, allowing your friend to have access to single pill and triple pill regimens. Your friend has every HIV med (including the single pill Atripla) available to him - except for those three and Complera (a combo pill containing elvitegravir)

(as a personal way to view this, after taking 25 meds over 20 yrs I have yet to take an II, so having resistance to that class is not a deal-breaker by any stretch of the imagination.)

you chould also point your friend to the AM Lessons sections on Understanding Drug Resistance and The Big Treatment Questions to help him become more knowledgeable about the disease he has and the treatment options.

[texaninnyc87]

He just told me he is resistant to a bunch of other stuff to so i told him im not his doctor and gave him this URL.

[newt]

His doc should do a phenotype resistance test which looks at drugs v HIV in a test tube and shows what works in his body.

Also his doc should look at expanded access to new resistance busting drugs.

Resistance is not absolute and there may still be a workable combination standard with treatment (but yer, maybe not).

Note that the guy reported some years back with multi drug resistant HIV did well on a very standard combo of Atripla (efavirenz/FTC/tenofovir) despite his resistance tests saying these wouldn't work.

Options depend on the results of resistance tests.

Yer, it might turn out to be a 2 x day combo or some older, less nice drugs for now, but it is gonna save his life, 2 x day/older drugs and there will be new drugs soon << might not be 2 x day/older drugs

DO NOT PANIC (please). This is often these days a solvable problem. There's plenty of time for panic if it turns out later it isn't.

- matt

[texaninnyc87]

thanks. i tried to convey most of this to him but i think the reality of it is that he probably needs to be more accountable for his own health and really educate himself on these issues. hopefully he starts asking some questions on his own. i know that once i started learning more about HIV it become a lot less scary!