Question
Should I switch from Kivexa, Reyataz and Norvir to Triumeq?
12 April 2023. Related: All topics, Changing treatment.
Good evening. I have been on treatment for about 12 years with Kivexa, Reyataz and Norvir. I have always had undetectable viral load and an average Cd4 of 650 cells. At the last visit, the doctor told me that he would change my treatment regimen with Triumeq.
1. Do you think this is a good idea, as long as viral load has always been undetectable?
2. When I start take Triumeq, do i have to take a few days break between the old treatment plan?
3. Do you think I need to do the test for the HLA-B*5701?(I mentioned that i did not get it when i starter the treatment, but i did not have any serious side effect)
4. Abacavir/lamivudine also contained Kivexa, as well as the new drug Triumeq.Is the renunciation of Reyataz and Norvir done gradually or suddenly?
Thank you in advance.
Answer
Hi, how are you doing?
It is great to hear how well you have been doing on treatment.
Even though you have always been undetectable with a healthy CD4 count, it is always good practise to make sure you are on the best treatment that works for you and is also available.
Your doctor suggesting this switch shows that they are actively looking for better options for yourself and keeping you involved with newer treatments. In the UK, BHIVA guidelines recommend that people are switched from older combinations, which you are on, to newer combinations. This is similar in the US.
Over time it is now recommended that people use a combination based on an integrase inhibitor. In this case this will be dolutegravir.
Is you current treatment a single pill or are you needing to take multiple? Triumeq is a single pill and there are no food requirements as to when you can take it. With your current treatment there is also a larger side effect profile. Have you ever had a problem with your current treatment? Triumeq is generally regarded as a combination with fewer and more mild side effects.
A break between your treatments would not be required. What time do you currently take your treatment? As Triumeq contains a drug called dolutegravir it is recommended to be taken in the morning. This is because it can cause trouble sleeping if taken later in the day. The switch between treatments can be immediate. There would be no time needed for weaning/reducing treatment.
The HLA testing should be done before starting treatment with Abacavir. This is because there is a risk of a hypersensitivity reaction. As you have already been taking a treatment that includes abacavir it can be assumed you are not positive for this. This means your risk for a hypersensitivity reaction would be low and there is now no benefit to testing.
Josh.
Comment