Frustration with new mix

[David84]

Hello All:
I would value some input on this one. Background: 22 yrs poz , mutiple resistances etc.. when last set of labs came in cd4  44  vl 96000 decided with doc time to switch to Aptivus and drop Lexiva. So the new mix is:
Aptivus, Norvir,Viread, Zerit and Fuzeon(since 2003). 

Anyhow, I am fustrated with side effects.. overall feel like flu with lots of trips to bathroom. (Thanks Norvir). Its dragging me down instead of boosting me up. I told the doc I would manage thru Oct. 4 with all this, but am thinking otherwise. Thinking of calling him today.. thoughts, comments, suggestions?

I really appreciate it! Thanks so much in advance.
Hugs
David

[newt]

Aptivus is used with the evil amount of 400mg Norvir a day. Prezista, newly licensed, uses 200mg a day.  Maybe this is an option.  Plus it is shaping up to be kinda stunning against PI resistance virus in many cases and seems to have less side effects. 

Which PI to replace Aptivus really depends on your PI mutations, there may be even more options (do you have a list?).

- matt

[David84]

Well I went.. we reviewed the list of mutations/resistances... not much to offer but Prezista. Took labs and will decide next monday.. so in the meantime his m.o. was to deal with things as they are for another week.  Going to investigate integrase inhibitors and CCR5 Blocker.. Don't know too much about either, but sure I will find out.

By the way Matt.. how you feeling? What did you find out?

David

[newt]

Hello D, I am, er fine

I would rather be on Prezista that Aptivus, resistance allowing, cos it's much less Norvir.

There's very good data on the integrase inhibitor MK-0518 here:  Integrase inhibitor MK-0518: early results show greater early potency than efavirenz.  It is shaping up to be a possible goodie. I say possible because it may stumble in Phase 3 of the trial process. It is untested in a "salvage" context, but lack of interactions with other drugs cleared by P450 pathway (eg Norvir), or with food, make it a good candidate for testing for this purpose. Phase 3 studies will use a 400mg 2 x day dose. The FDA is fast-tracking the approval process.  I believe there will be a compassionate access programme for the drug in the US from Sept/Oct time.

This may also be of interest (as a short-term intervention): Three-class experienced patients experience 1 log viral load reduction using monoclonal antibody TNX-355

- matt

[David84]

Thanks for info Matt..

Its all too confusing sometimes eh? Looks like there is an access program available for integrase inhibitor in US. Yet another discussion point for Monday with doc.

David