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I am HIV positive. Which medicine will you prefer instead of Sustiva?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

I am HIV positive. I am now 11 years viral load free. My cocktail consists of Sustiva, Isentress, and Epzicom. My doctor has suggested switching me to other due to the adverse effect of Sustiva. My genotyping indicates that I have a resistance to Ziagen and Epivir. What are your thoughts in this issue?

Answered by Dr. Sadaf Mustafa

Hello,

Welcome to icliniq.com. It depends on which type of side effects were you having from Sustiva (Efavirenz). I would be very careful before consider switching it around since you have been in remission for so long and the viral load is suppressed. I am not sure what is the sensitivity to other NNRTI (non-nucleoside reverse transcriptase inhibitors) since there are other medications in the same group that could be used instead of Sustiva. Also, there are alternative therapies where you can substitute the Sustiva with another class of HAART (highly active antiretroviral therapy). Do you have a copy of the sensitivity report with you? Can you share? Also, what are the side effects? I would suggest thinking twice before trying a different agent. But, if you have no choice, then starting a sister sensitive medication from the same class would be preferable in my opinion.

Patient's Query

Hi doctor,

Thank you for your response. I discussed with my doctor along with the genotyping, which he had not had. We decided to go with Genvoya. What is your opinion on this? As I am sensitive to all the components of this drug, shall I start with this medicine?

Answered by Dr. Sadaf Mustafa

Hello,

Welcome back to icliniq.com. It is actually a very good choice. It also has the convenience of once daily dosing. Just make sure that you have been checked for HBV (hepatitis B virus) and also have no liver related issues. This combination may flare the HBV infection. Also make sure that your kidney function is being checked at baseline and also periodically. If the creatinine clearance is less than 30 consider an alternative regimen.

Answered byDr. Sadaf Mustafa

Medically reviewed byiCliniq medical review team

Published At April 26, 2016
Reviewed AtNovember 26, 2024

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Dr. Sadaf Mustafa
Dr. Sadaf Mustafa

Internal Medicine

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