Academy Exchange

A patient recently returned to my care after living out of state for a year, and fostemsavir had been added to their regimen of Biktarvy. I don't have experience with fostemsavir and want to determine whether it warrants continuation.

Patient is a 55 y/o M who started I started on ART 8/2024 with Biktarvy with baseline labs demonstrating HIV RNA = 125,000; CD4 = 234 (16%); no RT, protease, or integrase drug resistance mutations. He was also diagnosed with Kaposi Sarcoma oral lesions but relocated several weeks after initial visit and prior to starting treatment. He is now back at our clinic, and records from outside health system note a suppressed viral load and CD4 of 289 (22%) in 9/2024. Fostemsavir was added at the initial visit 10/2024 with the documentation that it might "hold off damage to the immune system" and to "continue treatment due to high risk of developing life-threatening infections or cancers related to low CD4 count." At that time patient was receiving treatment with liposomal doxorubicin for KS. My understanding is that fostemsavir is approved for use with multidrug resistant HIV and patients who are highly treatment experienced. Are there other situations in which its currently being used? I don't want to discontinue it if it's addressing a clinical need with which I'm unfamiliar. 

Thank you in advance,

Emily Delmotte, NP

A patient recently returned to my care after living out of state for a year, and fostemsavir had been added to their regimen of Biktarvy. I don't have experience with fostemsavir and want to determine whether it warrants continuation.

Patient is a 55 y/o M who started I started on ART 8/2024 with Biktarvy with baseline labs demonstrating HIV RNA = 125,000; CD4 = 234 (16%); no RT, protease, or integrase drug resistance mutations. He was also diagnosed with Kaposi Sarcoma oral lesions but relocated several weeks after initial visit and prior to starting treatment. He is now back at our clinic, and records from outside health system note a suppressed viral load and CD4 of 289 (22%) in 9/2024. Fostemsavir was added at the initial visit 10/2024 with the documentation that it might "hold off damage to the immune system" and to "continue treatment due to high risk of developing life-threatening infections or cancers related to low CD4 count." At that time patient was receiving treatment with liposomal doxorubicin for KS. My understanding is that fostemsavir is approved for use with multidrug resistant HIV and patients who are highly treatment experienced. Are there other situations in which its currently being used? I don't want to discontinue it if it's addressing a clinical need with which I'm unfamiliar. 

Thank you in advance,

Emily Delmotte, NP

A patient recently returned to my care after living out of state for a year, and fostemsavir had been added to their regimen of Biktarvy. I don't have experience with fostemsavir and want to determine whether it warrants continuation.

Patient is a 55 y/o M who started I started on ART 8/2024 with Biktarvy with baseline labs demonstrating HIV RNA = 125,000; CD4 = 234 (16%); no RT, protease, or integrase drug resistance mutations. He was also diagnosed with Kaposi Sarcoma oral lesions but relocated several weeks after initial visit and prior to starting treatment. He is now back at our clinic, and records from outside health system note a suppressed viral load and CD4 of 289 (22%) in 9/2024. Fostemsavir was added at the initial visit 10/2024 with the documentation that it might "hold off damage to the immune system" and to "continue treatment due to high risk of developing life-threatening infections or cancers related to low CD4 count." At that time patient was receiving treatment with liposomal doxorubicin for KS. My understanding is that fostemsavir is approved for use with multidrug resistant HIV and patients who are highly treatment experienced. Are there other situations in which its currently being used? I don't want to discontinue it if it's addressing a clinical need with which I'm unfamiliar. 

Thank you in advance,

Emily Delmotte, NP

A patient recently returned to my care after living out of state for a year, and fostemsavir had been added to their regimen of Biktarvy. I don't have experience with fostemsavir and want to determine whether it warrants continuation.

Patient is a 55 y/o M who started I started on ART 8/2024 with Biktarvy with baseline labs demonstrating HIV RNA = 125,000; CD4 = 234 (16%); no RT, protease, or integrase drug resistance mutations. He was also diagnosed with Kaposi Sarcoma oral lesions but relocated several weeks after initial visit and prior to starting treatment. He is now back at our clinic, and records from outside health system note a suppressed viral load and CD4 of 289 (22%) in 9/2024. Fostemsavir was added at the initial visit 10/2024 with the documentation that it might "hold off damage to the immune system" and to "continue treatment due to high risk of developing life-threatening infections or cancers related to low CD4 count." At that time patient was receiving treatment with liposomal doxorubicin for KS. My understanding is that fostemsavir is approved for use with multidrug resistant HIV and patients who are highly treatment experienced. Are there other situations in which its currently being used? I don't want to discontinue it if it's addressing a clinical need with which I'm unfamiliar. 

Thank you in advance,

Emily Delmotte, NP