Question

What if my combination fails and can you help neuropathy?

17 October 2016. Related: Adherence, All topics, Resistance, Side effects, Support.

Hi, I am HIV positive for 16 years and I am on ART – at present ATV/R + Truvada on second line therapy. if fails are many options are available in India? My life span is another 20 years to get it?  neuropathy (ddi d4t) is chronic. how to deal this disease. please help.

Answer

Answer: Simon Collins

Hi

Thanks for your questions.

First and easiest, is that if your viral load is currently undetectable and you don’t miss your meds, then this combination will not fail. You could use it for 20 years for example.

Resistance can only develop in the following 3 ways:

1. If you are regularly late with meds or miss doses.
2. If you don’t take atazanavir/ritonavir with food – this is important, otherwise you only get half the dose.
3. If you take any other medicines that interact with your meds. Antacid tablets to settle your stomach can sometimes interact with atazanavir – so please talk to your doctor about this.

If you are careful about these three things, your current combination will not fail.

There will be other choice though in the future. For example a new drug called dolutegravir will soon be available as a generic medicine. This might help you feel more confident that there is a back up, just in case.

The neuropathy question is more difficult. This side effect of the early drugs you took – d4T and ddI – currently cannot be reversed. If this is causing pain, then some painkillers can sometimes work but please talk to your doctor about your choices.

More information about how to manage neuropathy is at this link.
https://i-base.info/guides/side/peripheral-neuropathy