Question
What are alternatives to Atripla or PIs when starting treatment?
21 June 2011. Related: All topics, Starting treatment.
Treatment naive and recently infected, no resistance and CD4 always above 500. I’m not keen on PI’s or Atripla.
What options of treatment would you consider for someone in my position?
Answer
A section in the i-Base Introduction to Combination Therapy (see ‘Which Drugs, Which Combinations’) includes mores information on these options.
Usually this would include either another NNRTI (nevirapine or etravirine). Although maraviroc is not approved in Europe as a first-line option is is sometimes used off-label if your doctor thinks this is appropriate.
Another option includes using raltegravir which is an integrase inhibitor. Access to raltegravir as a first-line option varies depending on where you live in the UK. This is because there are different prices in different areas and it is usually more expensive than other first or even second-line drugs.
This link includes information on all current HIV drugs. At the bottom of each of the ‘More information’ pages we have included links to the full prescribing information on the EMA (Europeans Medicines Agency) website.
You would probably need to have a medical reason not to use efavirenz or PIs as these are usually the basis of most first-line combinations because they are both active against HIV and are generally safe and tolerable. However, treatment is very individual, so it is important that you find out about alternatives in case they are more appropriate for you.
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