Hi, how are you doing?<\/p>\n
It is great to hear how well you have been doing on treatment.<\/p>\n
As you have mentioned that your kidney function has been declining, has it tested out of a healthy range? e.g., above 1.4 mg\/dl if you are a man and 1.2 mg\/dl if you are a woman.<\/p>\n
It is good that the cystatin C test has tested within a normal range.<\/p>\n
As you age it is expected for kidney function to slowly decline. As you are still testing in a normal range albeit with a slight increase this is an expected change.<\/p>\n
Do you tolerate your treatment well\/do you have any problems aside from this change in kidney function on your current regimen?<\/p>\n
Switching to Biktarvy is a common switch from boosted combinations. This is because they are generally better tolerated than non-boosted combinations. Moving to a TAF based regimen is kidney-protective and will help to avoid any further risk of treatment causing your kidney function to decline.<\/p>\n
Have you been on other treatments before? and have you had any problems with resistance before?<\/p>\n
If you have not and switching is recommended, there will be no risk of switching. You can move between these treatments and it will not risk treatment failure or lead to a viral load rebound.<\/p>\n
Josh.<\/p>\n","protected":false},"excerpt":{"rendered":"
Should I switch treatment due to declining kidney function?<\/p>\n
I have been on a boosted protease inhibitor (Ritonavir and Lopinavir) plus TDF and 3TC for about 7 years (Since I got diagnosed). My VL has been stable and undetectable all this time (less than 40.) CD4 has increased from an initial pre-treatment of below 200 to now in the range of 500. Finally, baseline VL was about 5 million when I started pre-treatment.<\/p>\n
Concern – my serum creatinine seems to be declining mildly through the years but stabilized at about the 1.2 mg\/dl range in the last 4 years. This year it has declined to a new high of 1.4 mg\/dl. My doc also requested a cystatin C test recently but that shows a more normal range (just on the the upper limit).<\/p>\n
Should I switch to a NON-TDF based regimen? A treatment with TAF (BIKTARVY) is right now avail here in my country. What are the risks of treatment failure from switching?<\/p>\n","protected":false},"author":18,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7,9,10],"tags":[],"class_list":["post-22652","post","type-post","status-publish","format-standard","hentry","category-all-topics","category-cd4-and-viral-load","category-changing-treatment"],"_links":{"self":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts\/22652","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/users\/18"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/comments?post=22652"}],"version-history":[{"count":1,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts\/22652\/revisions"}],"predecessor-version":[{"id":22653,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts\/22652\/revisions\/22653"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/media?parent=22652"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/categories?post=22652"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/tags?post=22652"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}