Question
What drugs can I use in my next treatment and what drugs are coming next?
24 August 2007. Related: All topics, Changing treatment, Resistance, Side effects.
I have recently stopped my HIV Treatment (Sustiva; and Kivexa, due to side effects) for a treatment break.
I am now considering starting a new regime but I would rather look in to the drugs that could be available next so i may research them myself.
Do you have any suggestions of what could be next, or to what I should ask why doctor about?
Many thanks,
Answer
Hi
Your choices will depend on your previous treatment history, the side effects you had before, and when you need to start treatment.
If Sustiva (efavirenz) and Kivexa (abacavir + 3TC) combination was your first ever treatment, and when you stopped treatment your viral load was undetectable – ie this was just for side effects and that you haven’t developed resistance – then you have a lot of choice based on already approved drugs.
If the reason you stopped treatment was related to Kivexa – especially if you had a hypersensitivity reaction (rash, fever etc) then you can;t use this drug again.
If you stopped because of Sustiva’s side effects (sleep disturbance, nightmares, mood swings, increased anxiety or depression etc) then Kivexa is fine to use again but you need to chose a different third drug.
Depending on your viral load and CD4 count, this could be:
- atazanavir/ritonavir (boosted Reyataz) – a once-daily protease inhibitor
- lopinavir/r (Kaletra) – a twice daily protease inhibitor
- nevirapine (Viramune) – a twice-daily NNRTI
- darunavir/r – an approved protease inhibitor that was developed to be used in people with a lot of resistance, but which came out better against Kaletra in a recent trial of people in earlier treatment.
The information in the i-Base ‘Changing treatment’ guide should also be useful
If you want to research drugs that will be available in the UK over the next year or so, these are likely to include:
- maraviroc – a CCR5 inhibitor recently approved in the US
- raltegravir – an integrase inhibitor not yet approved but which has produced very good early results in both people on their first treatment and people who have drug resistance
- etravirine – a new NNRTI
Most of these drugs are being developed for people who have resistance to current drugs – though raltegravir has shown promising results in an early treatment naive study.
For recent reports about any of these treatments, try searching the i-Base website. Articles from the i-Base HIV Treatment Bulletin reports latest results from trials and conferences, though the language is fairly medical.
Other community-based sites with good information on each drug include:
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