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Multiple Side-effects

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Matths:
Hi again,

Given that you currently do not take any HIV treatment, they can test resistance with today’s tools which are much more precise than back when your “resistance” pattern was first established. I would encourage you to initiate that step if it hasn’t been done so yet. I believe that Dovato (which I am taking for full disclosure) can only been prescribed if neither of the 2 components is affected by resistance (but please double-check with your doctor).

You are correct, Prezista falls into the group of protease inhibitors. But there are up to 10 protease inhibitors approved to date, the more recent ones being better studied in trials and more experience. So, this class could be an option for you to consider.

Final comment: I understand why you don’t take any treatment currently. However, if this was me, I would not sit and wait because untreated HIV has the potential to harm you and others potentially, and with today’s treatment options there is a very high possibility that also you will find a combo that works for you to keep you undetectable. Best of luck, Matt

Quint1976:
Hi Matt,

Thanks for replying to my post.

hmmm i will look into that Protease inhibitor story and see what i can do with that.

Second i was with my doctor last Wednesday for a check-up and asked the very same thing you advised me by checking resistance again.
She told me after i asked that it was not possible to do so since resistance testing, after testing when diagnosed, would be pointless since i do not use meds at the moment so they could not see what kind of specific hiv tribe would be resistant to the meds. I told her that was the first time i heard of it that you need to be on meds in order for them to test what kind of meds i was resistant to.
I was under the impression that you could always test it with or without the meds since in a lab setting they would use various hiv med components to test resistance but apparently not ??
Anyway she went on to say labs were okay at this time so no hurry to start meds....

Regarding your last comment, point taken and i totally agree....sit and do nothing will do me more harm than taking action.
I just have to figure out what steps i could take next.....

Jim Allen:
Viramune/Truvada, Stribild, Genvoya, Biktarvy

 ???

It's a bit odd that they keep giving you combinations containing mainly the same drugs TAF/TDF and yet expect a different outcome. 

However, there are still plenty of other combinations possible, and I hope you find something that suits you better sooner rather than later.


--- Quote ---The reasoning my doctor has for not giving me Dovato is that she is questioning if two components can be enough to keep my HIV in check without developing resistance to both components including Dolutegravir.
--- End quote ---

DTG is not everyone's cup of tea, works fine for me, though. If the concern for developing resistance is that high prehaps, your doctor might consider twice daily DTG (so double doze of DTG).

https://www.natap.org/2013/IAS/IAS_21.htm
https://www.aidsmap.com/news/oct-2011/dolutegravir-potent-twice-daily-works-better-integrase-resistant
https://journals.sagepub.com/doi/full/10.3851/IMP3275

Anyhow, best of luck.

Quint1976:
Hi Jim,

Thanks for your reply.

Yeah i know, i never understood it either....
I will look into that DTG option and check out those links you provided.

Thanks again for helping me with this info Jim, much appreciated !

Matths:
Hi again,

With all due respect to your doctor, but the comment regarding resistance testing is flat out wrong. If my doctor said something that wrong to me, I would immediately switch (and I am big against doctor shopping!!). However, here your doctor got one basic of HIV care fundamentally wrong!!

I also agree with Jim on the prescriptions for the same class of drugs you are believed to be resistant to. If you had in the past a good response defined by lowering your virus load, and you completely stopped your medication, there is little reason to assume that new resistance has developed and it can assumed that you will continue to respond to this class (unless the side effects prevent you from taking them). However, as you correctly pointed out, 2 drugs like in Dovato provides a smaller chance of side effects.

I must also reiterate that Dolutegravir is not everyone’s cup of tea. For me it works and given its high barrier of resistance it’s my backbone treatment and keeps me U.

Altogether, I suggest you continue looking out for yourself, may want to consider the above and keep us posted on how you proceed, best Matt

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