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Author Topic: Two dropped regimens. So, now what?  (Read 4371 times)

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Offline Zohar

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  • Posts: 252
Two dropped regimens. So, now what?
« on: June 23, 2010, 04:59:55 pm »
I've been on both Atripla and Nevirapine and had to stop both regimes due to side effects. It seems that the next step now is PIs, although I've always been wary of them as they seem to have an even broader side effect profile.

Do you think my apprehension over PIs is justified?

If you were in this position which combination would you next be considering?
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Offline Miss Philicia

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Re: Two dropped regimens. So, now what?
« Reply #1 on: June 23, 2010, 05:11:17 pm »
Apprehension over PIs isn't particularly justified in the case of either Prezista or Reyataz, definitely less so with the former.  You could always consider an integrase inhibitor like Isentress if you don't want to go to PIs.
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Offline Zohar

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Re: Two dropped regimens. So, now what?
« Reply #2 on: June 23, 2010, 06:07:15 pm »
I've read a lot of positive things about Isentress on these forums, but I live in the UK and it would be  quite unusual for it to be prescribed at this stage, where the issues are side effects, rather than resistance.
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Offline newt

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Re: Two dropped regimens. So, now what?
« Reply #3 on: June 23, 2010, 06:22:55 pm »
The reports, eg on lipodystrophy, for PIs mainly relate to older drugs.

However, depending on your genetics, yes PIs can be a pain and have serious side effects, but no more/less than NNRTIs like efavirenz/Atripla. It really depends on you and how you react to the particular drugs.

There are advantages to PIs, for example they tend to give a modestly better immunological response (er, bit more rise in CD4 count) than NNRTIs, and are more forgiving on adherence/resistance.

So basically, yes, I think in 2010 your apprehension is unjustified. BUT the proof of the pudding is in the eating. It would be perfectly reasonable and within UK guidelines to move fairly swiftly to an integrase inhibitor if 1 or 2 PI based combos didn't work out.

Good luck

- matt
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Offline Billy B

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  • Posts: 392
Re: Two dropped regimens. So, now what?
« Reply #4 on: June 24, 2010, 01:04:15 pm »
Quote from: Zohar on June 23, 2010, 06:07:15 pm
I've read a lot of positive things about Isentress on these forums, but I live in the UK and it would be  quite unusual for it to be prescribed at this stage, where the issues are side effects, rather than resistance.

All I had to tell my IDS was that I going insane on Artipla and that I had my neighbor come get my guns. He wrote my new prescriptions for Isentress and Truvada and I was on my way. I have been on these meds since 3/16/10 and I have had a few dreams but they are about events from 30 years ago when I was young and hot and all my friends were still alive.
Peace,
Billy
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VL 4420 CD4 340 CD4% 24   3/15/10 Started I&T
VL  UD   CD4 340 CD4% 26.5 05/13/10
VL  UD   CD4 360 CD4% 27.1 08/3/10
VL  UD   CD4 310 CD4% 28.4 11/22/10
VL  UD   CD4 420 CD4% 27.9 02/11/11
VL  UD   CD4 370 CD4% 26.4 06/08/11
VL  UD   CD4 360 CD4% 27.7 09/23/11
VL  UD   CD4 370 CD4% 28.3 01/20/12
VL  UD   CD4 430 CD4% 28.8 05/11/12
VL  UD   CD4 370 CD4% 28.1 09/07/12
VL  UD   CD4 390 CD4% 32.3 03/14/13
VL  UD   CD4 450 CD4% 29.8 09/10/13
VL  UD   CD4 430 CD4% 31.0 04/29/14
VL  UD   CD4 520 CD4% 34.8 11/05/15
VL  UD   CD4 440 CD4% 33.5 03/10/15
VL  UD   CD4 450 CD4% 30.5 08/23/16
VL  UD   CD4 510 CD4% 34.0 07/21/20  (Biktarvy)

Offline Zohar

  • Member
  • Posts: 252
Re: Two dropped regimens. So, now what?
« Reply #5 on: June 24, 2010, 02:28:17 pm »
Quote from: Billy B on June 24, 2010, 01:04:15 pm
All I had to tell my IDS was that I going insane on Artipla and that I had my neighbor come get my guns. He wrote my new prescriptions for Isentress and Truvada and I was on my way. I have been on these meds since 3/16/10 and I have had a few dreams but they are about events from 30 years ago when I was young and hot and all my friends were still alive.
Peace,
Billy

I'm guessing you're based in the States, right?
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''Poor is the man whose pleasures depend on the permission of another.''

Offline Billy B

  • Member
  • Posts: 392
Re: Two dropped regimens. So, now what?
« Reply #6 on: June 24, 2010, 11:57:19 pm »
Quote from: Zohar on June 24, 2010, 02:28:17 pm
I'm guessing you're based in the States, right?

Yes,
Billy
Logged
VL 4420 CD4 340 CD4% 24   3/15/10 Started I&T
VL  UD   CD4 340 CD4% 26.5 05/13/10
VL  UD   CD4 360 CD4% 27.1 08/3/10
VL  UD   CD4 310 CD4% 28.4 11/22/10
VL  UD   CD4 420 CD4% 27.9 02/11/11
VL  UD   CD4 370 CD4% 26.4 06/08/11
VL  UD   CD4 360 CD4% 27.7 09/23/11
VL  UD   CD4 370 CD4% 28.3 01/20/12
VL  UD   CD4 430 CD4% 28.8 05/11/12
VL  UD   CD4 370 CD4% 28.1 09/07/12
VL  UD   CD4 390 CD4% 32.3 03/14/13
VL  UD   CD4 450 CD4% 29.8 09/10/13
VL  UD   CD4 430 CD4% 31.0 04/29/14
VL  UD   CD4 520 CD4% 34.8 11/05/15
VL  UD   CD4 440 CD4% 33.5 03/10/15
VL  UD   CD4 450 CD4% 30.5 08/23/16
VL  UD   CD4 510 CD4% 34.0 07/21/20  (Biktarvy)
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