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  • 1.  ART regimen change with upcoming Kidney Transplant

    Posted 09-11-2025 14:28

    Hi all,

    One of my ID providers has an HIV patient that he just picked up from another provider. The patient is non-urgently being planned for kidney transplant in the future. He is currently on Symtuza due to history of resistances. His transplant ID provider reached out hoping to maybe get this patient off a boosting agent which would interact with future immunosuppressing medications post-transplant (tacrolimus, prednisone). Attached is most, if not all, of the patient's genotype history in Stanford. I have also copied the mutations below.
    The patient is currently undetectable on Symtuza. I would love to gather the community's thoughts on the patient and potential options for him moving forward. Thank you.
    Patient information:
    When Diagnosed/Mode of transmission: 2007
    Past ARV: Atripla, Epzicom, Sustiva, Prezista, Norvir, Tivicay, Lamivudine, Abacavir, Juluca, Pifeltro
    Current: Symtuza
    Risk: MSM
    Resistances:
    Rt: V60I, A98S, K101E, Q102K, D121Y, K122E, E138A, I142V, C162S, D177E, T200A, V245I/M, D250E, I257L, R277K, T286A, V293I, V60I, K64R, A98S, K101R, Q102K, V106I/L, D121Y, K122E, E138E/A, I142V, C162S, D177D/E, I178I/L, Y181C, T200A, H221Y, E248D/N, D250D/G, R277K, T286A, V293I
    INSTI: D6E, S17N, S39N, M50I, L101I, T124A, V234L, R263K
    PI: L10V, L19E, K20R, D60E, I62I/V, L63P, H69Y, I72V
    Hep A Immune 2015
    Hep B No evidence of chronic Hep B (borderline immunity)
    Hep C neg 


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    Kristen Lindauer, PharmD, BCPS, AAHIVP
    Fallon, NV
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  • 2.  RE: ART regimen change with upcoming Kidney Transplant

    Posted 09-11-2025 15:27

    This might be one of  the rare cases where doing a Trofile assay may be helpful.  This will likely need to be a Trofie DNA assay if the patient is suppressed.   Then, consider using maraviroc if R5 trophic.



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    Adam Zweig
    San Diego CA
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  • 3.  RE: ART regimen change with upcoming Kidney Transplant

    Posted 09-11-2025 15:49

    agree with the trial of a trophile, as some maraviroc is good in transplant as there's data it also reduces potential rejection risk.

    otherwise atypical as it sounds, TAF/FTC/BIC+LEN ?  Would really need a good conversation with the transplant team, as there's some limited drug interactions with tacrolimus, but not prohibitive.  They'd just need to realize levels might be a bit unusual, and they'd need to think through waning levels and interactions as you approach the tail.  But regular tacro monitoring should be ok there.

    Finally there's just some people who you shouldn't move off their current meds, if that's whats FINALLY brought them into control.  Yet they still can get life-affirming transplant.  The transplant issue will also be the tacro-PI interaction - leaves the kidney at greater risk of rejection over time as immunosuppressant levels are variable.  But if teams are struggling with that, we have moved some patients off tacrolimus and onto belatacept as an alternative immunosuppressant, which has worked well.  Not "routine", but certainly an option that works.  But i'd really strongly recommend a good chat with their TxID doc and their transplant pharmacist.

    good luck, and happy to help further if you need!!

    cameron

    (919) 599-7252



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    Cameron Wolfe
    Durham NC
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  • 4.  RE: ART regimen change with upcoming Kidney Transplant

    Posted 09-11-2025 18:30

    How is it possible that there is so much NNRTI resistance with no NRTI resistance?    Seems very strange to me.



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    Adam Zweig
    San Diego CA
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  • 5.  RE: ART regimen change with upcoming Kidney Transplant

    Posted 09-15-2025 15:10
    Edited by Kristen Lindauer 09-15-2025 15:11

    Thanks for the input so far. Anyone have experience with fostemsavir?



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    Kristen Lindauer, PharmD, BCPS, AAHIVP
    Fallon, NV
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  • 6.  RE: ART regimen change with upcoming Kidney Transplant

    Posted 09-15-2025 17:10

    Fostemsavir with two NRTIs should work, if we can believe the resistance tests are accurate.   I would not be a fan of using an increased dose of a PI without a booster, due to tolerability and pharmacokinetic concerns.



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    Adam Zweig
    San Diego CA
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  • 7.  RE: ART regimen change with upcoming Kidney Transplant

    Posted 09-17-2025 06:26

    I'd be very skeptical of those resistance test results, which show no NRTI resistance despite plenty of resistance to the other drug classes.  That's not impossible, but it's improbable. I wouldn't use a combination that included only NRTIs with a single fully active agent.



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    Joel Gallant, MD, MPH
    Johns Hopkins University
    Baltimore, MD

    AXCES Research Group
    Santa Fe, NM
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  • 8.  RE: ART regimen change with upcoming Kidney Transplant

    Posted 09-17-2025 11:36

    Joel,

    What would you recommend then?  Maybe two NRTIs/fostemsavir/lenacapavir?   There may be a DDI between len and tacrolimus, but I guess tacrolimus levels could be monitored.  I still would recommend doing a  trofile DNA assay and using maraviroc if R5 trophic, although that may be wishful thinking.



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    Adam Zweig
    San Diego CA
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