Academy Exchange

Hello,

I would to solicit some thoughts on simplifying my pt's regimen.  She really wants to be on a single tablet regimen:

58 y/o female diagnosed with HIV in 2006, noted for some low level viremia but generally controlled.  Reports she was previously on Trizivir.  She is currently on Descovy, Prezcobix and Tivicay (since 2017) and suppressed.  She is noted for NRTI mutations of M41L, M184V and T215Y and NNRTI A98G.  Other medical problems are hypertriglyceridemia and obesity, otherwise healthy, and she is on no other meds other than her ARVs.

I remember the presentation about the NADIA study from one of the conferences which seem to fit my patient (please anyone correct me if I am wrong).  From the NADIA study in pts with NRTI resistance, looks like I can either put her on a Truvada+DTG or Truvada+DRV/r regimen.  In looking at the study there were 4 failures in the DTG with resistance versus none in the DRV/r.  Due to her hypertriglyceridemia, which maybe coming from the PI as she reports generally a healthy diet, I'm considering putting her on Truvada+DTG.  However, I'm also concerned about the failure with resistance in the DTG arm. 

Any thoughts of a single tablet regimen for the patient?  She really wants to be on a single pill.

Thank you everyone!

I have attached a copy of her only resistance test on file, the results from Standford HIV databse and VL results.

Hello,

I would to solicit some thoughts on simplifying my pt's regimen.  She really wants to be on a single tablet regimen:

58 y/o female diagnosed with HIV in 2006, noted for some low level viremia but generally controlled.  Reports she was previously on Trizivir.  She is currently on Descovy, Prezcobix and Tivicay (since 2017) and suppressed.  She is noted for NRTI mutations of M41L, M184V and T215Y and NNRTI A98G.  Other medical problems are hypertriglyceridemia and obesity, otherwise healthy, and she is on no other meds other than her ARVs.

I remember the presentation about the NADIA study from one of the conferences which seem to fit my patient (please anyone correct me if I am wrong).  From the NADIA study in pts with NRTI resistance, looks like I can either put her on a Truvada+DTG or Truvada+DRV/r regimen.  In looking at the study there were 4 failures in the DTG with resistance versus none in the DRV/r.  Due to her hypertriglyceridemia, which maybe coming from the PI as she reports generally a healthy diet, I'm considering putting her on Truvada+DTG.  However, I'm also concerned about the failure with resistance in the DTG arm. 

Any thoughts of a single tablet regimen for the patient?  She really wants to be on a single pill.

Thank you everyone!

I have attached a copy of her only resistance test on file, the results from Standford HIV databse and VL results.

Hello,

I would to solicit some thoughts on simplifying my pt's regimen.  She really wants to be on a single tablet regimen:

58 y/o female diagnosed with HIV in 2006, noted for some low level viremia but generally controlled.  Reports she was previously on Trizivir.  She is currently on Descovy, Prezcobix and Tivicay (since 2017) and suppressed.  She is noted for NRTI mutations of M41L, M184V and T215Y and NNRTI A98G.  Other medical problems are hypertriglyceridemia and obesity, otherwise healthy, and she is on no other meds other than her ARVs.

I remember the presentation about the NADIA study from one of the conferences which seem to fit my patient (please anyone correct me if I am wrong).  From the NADIA study in pts with NRTI resistance, looks like I can either put her on a Truvada+DTG or Truvada+DRV/r regimen.  In looking at the study there were 4 failures in the DTG with resistance versus none in the DRV/r.  Due to her hypertriglyceridemia, which maybe coming from the PI as she reports generally a healthy diet, I'm considering putting her on Truvada+DTG.  However, I'm also concerned about the failure with resistance in the DTG arm. 

Any thoughts of a single tablet regimen for the patient?  She really wants to be on a single pill.

Thank you everyone!

I have attached a copy of her only resistance test on file, the results from Standford HIV databse and VL results.

Hello,

I would to solicit some thoughts on simplifying my pt's regimen.  She really wants to be on a single tablet regimen:

58 y/o female diagnosed with HIV in 2006, noted for some low level viremia but generally controlled.  Reports she was previously on Trizivir.  She is currently on Descovy, Prezcobix and Tivicay (since 2017) and suppressed.  She is noted for NRTI mutations of M41L, M184V and T215Y and NNRTI A98G.  Other medical problems are hypertriglyceridemia and obesity, otherwise healthy, and she is on no other meds other than her ARVs.

I remember the presentation about the NADIA study from one of the conferences which seem to fit my patient (please anyone correct me if I am wrong).  From the NADIA study in pts with NRTI resistance, looks like I can either put her on a Truvada+DTG or Truvada+DRV/r regimen.  In looking at the study there were 4 failures in the DTG with resistance versus none in the DRV/r.  Due to her hypertriglyceridemia, which maybe coming from the PI as she reports generally a healthy diet, I'm considering putting her on Truvada+DTG.  However, I'm also concerned about the failure with resistance in the DTG arm. 

Any thoughts of a single tablet regimen for the patient?  She really wants to be on a single pill.

Thank you everyone!

I have attached a copy of her only resistance test on file, the results from Standford HIV databse and VL results.

Hello,

I would to solicit some thoughts on simplifying my pt's regimen.  She really wants to be on a single tablet regimen:

58 y/o female diagnosed with HIV in 2006, noted for some low level viremia but generally controlled.  Reports she was previously on Trizivir.  She is currently on Descovy, Prezcobix and Tivicay (since 2017) and suppressed.  She is noted for NRTI mutations of M41L, M184V and T215Y and NNRTI A98G.  Other medical problems are hypertriglyceridemia and obesity, otherwise healthy, and she is on no other meds other than her ARVs.

I remember the presentation about the NADIA study from one of the conferences which seem to fit my patient (please anyone correct me if I am wrong).  From the NADIA study in pts with NRTI resistance, looks like I can either put her on a Truvada+DTG or Truvada+DRV/r regimen.  In looking at the study there were 4 failures in the DTG with resistance versus none in the DRV/r.  Due to her hypertriglyceridemia, which maybe coming from the PI as she reports generally a healthy diet, I'm considering putting her on Truvada+DTG.  However, I'm also concerned about the failure with resistance in the DTG arm. 

Any thoughts of a single tablet regimen for the patient?  She really wants to be on a single pill.

Thank you everyone!

I have attached a copy of her only resistance test on file, the results from Standford HIV databse and VL results.