Question
I have multi-drug resistant HIV, can I stop the T-20?
13 August 2010. Related: All topics, Resistance, Side effects.
I am currently on darunavir, raltegravir, norvir, etravirine, epivir and T20. I have been on treatment since 1996 and have resistance to most ARVs. Due to injection site reactions, I am considering substituting maraviroc for T20 and would like advice on whether this is a good idea or not.
My blood has been sent for a tropism test in the UK which shows I have mostly R5 tropic virus and have a small amount of X4 tropic virus.
Answer
Thank you for your question.
Despite there only being a small amount of the X4 tropic virus, if you suppress all the R5 tropic virus using maraviroc then the virus would just entirely shift to X4.
An alternative would be, based on a very careful review of resistance history, to stop T-20 and monitor the viral load weekly. At the first sign of a viral rebound (an increase in your viral load), you could restart with T-20 and likely resuppress the virus again but these may be some complications.
The potency of raltegravir, darunavir and etravirine together may be sufficient to maintain viral suppression once you stop the T-20.
Given the important quality of life issues you were explaining with regards to the difficulty of administration of T-20, this will make a big impact on your life. It should also be safe and effective.
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