Even in the case of a highly resistant virus to AZT/3TC/NVP and ABC/3TC/EFV, switching to TDF/3TC/DTG should have been beneficial, potentially achieving complete viral suppression-unless she had previously failed treatment with integrase strand transfer inhibitors (INSTIs) such as EVG, RAL, or DTG. If she hasn't been exposed to INSTIs before, we would expect her to respond, but we observe no response at all.
It's essential to rule out adherence issues. Additionally, if she hasn't received darunavir (DRV) or any other protease inhibitor (PI) in the past, she should respond favorably to the TDF/FTC DRV regimen.
If ypu can provide genotype results or information about other previous drugs (if she took them) I could be more heplfull.
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William Lenis
Fundacion Valle del Lili
Cali
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Original Message:
Sent: 10-09-2024 07:56
From: Obet Sibanda
Subject: Management of HIV amongst adolescence
A 13 year old adolescent girl in rural Zimbabwe was initiated on ART in February 2016 (Zidolam N).
In October 2018 she was switched to ABC/ 3TC/Efavirenz
December 2020 switched to Tenolam D
Viral load is as follows
2/20 35188
6/22. 173743
4/23. 1170
8/23. 97400
2/24. 160 077
8/24. 192 104
Crag negative.
Lives with grandmother who verbalises that she gives her medication
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Obet Sibanda
Gweru
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