Question
Can I return to my first ARVs – I have side effects with second-line?
28 November 2016. Related: All topics, Changing treatment.
Hello can i change from second line back to first line cz the second line is giving me too much problems with side effects.
Answer
Thanks for getting in touch.
For me to be able to answer I need to know why you changed the first treatment?
If this was because your viral load had either increased or not become undetectable, then the first treatment was not working well enough.
This means going back to the first treatment would not be good.
If you changed for other reasons, and your viral load was undetectable when you changed, then you can use the first treatment again.
What treatment were you taking and what are you now taking now?
It would also help to know your CD4 and viral load? Also, which country do you live in?
Hello Mercy and thanks for getting in touch.
Please discuss this with your doctor as they need to evaluate the situation where you are based and can provide you with a safe option that is good for you.
Do you know why you are on second line treatment?
I am on second line of Arvs but one the drugs are not available. Can I change and go back to first line
Dear Lemlem, thanks for your question. You didn’t include the name of the meds in the second-line combination, but I assume this might be a protease inhibitor based combination using either lopinavir/r or darunavir? If these are not available for supply or other issues, the switching to a fixed-dose combination of TDF+3TC+DTG is also okay, but the viral load at the time of all these treatment changes is also important.
If viral load has been undetectable at every switch, and it is undetectable now, then switching to TDF+3TC+DTG will be okay because there are no complications from drug resistance. If viral load was detectable on earlier combinations, especially if viral load continued at high levels, then it would be better to take advice from a virologist who has their treatment history, preferably with a recent drug resistance test if available.
Please realise that I am not a doctor, but the information above is based on current WHO HIV guidelines.
I have a patient four years back, she was on first line (TDF+3TC+EFV) at that time she had high viral load and low CD4 count and she was critically sick (treatment failure) and she switched to second line drugs currently one of the drug in second line is not available so can I change it to TDF+3TC+DTG?