Results

Mutations: None
Comorbidities: tb
Comedications: Isoniazid, rifapentine
Treatment history: None
Current regimen: DRV/c/TAF/FTC (Symtuza)
Adherence: Administration preference: Penalize IV/IM/SC dosing
CD4: ≤ 200
Viral load: Low (200 - 100,000)
HLA-B5701: Negative
Tropism: Unknown
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Score Code Regimen Weighted Score Active Drugs Total Pills Frequency (x/day)
1 BIC/TAF/FTC 0.75 2 1 1
1 DTG/TDF/3TC 0.75 2 1 1
1 DTG+TAF/FTC 0.75 2 2 1
1 DTG+TDF/FTC 0.75 2 2 1
1 DRV/c/TAF/FTC [Current regimen] 1.25 2 1 1
1 DRV/c+TDF/FTC 1.35 2 2 1
1 DRV/r+TAF/FTC 1.45 2 3 1
2 DRV/r+TDF/FTC 1.55 2 3 1
2 DTG+DRV/c/TAF/FTC 2 3 2 1
2 DRV/c+BIC/TAF/FTC 2.1 3 2 1
2 DTG+DRV/c 2.25 2 2 1
2 DRV/r+BIC/TAF/FTC 2.3 3 3 1
2 DTG+DRV/r+TAF/FTC 2.5 3 4 1
3 DRV/c+DTG/TDF/3TC 2.6 3 2 1
3 DOR+BIC/TAF/FTC 2.75 3 2 1
3 DTG+DOR/TDF/3TC 2.76 3 2 1
3 DTG+DRV/r 2.8 2 3 1
3 DTG+DRV/c+DOR 2.81 3 3 1
3 DOR+DRV/c/TAF/FTC 2.85 3 2 1
3 DRV/c+DTG/RPV 2.86 3 2 1
3 DTG+RPV/TAF/FTC 2.86 3 2 1
3 DTG+RPV/TDF/FTC 2.86 3 2 1
3 RPV+DTG/TDF/3TC 2.86 3 2 1
3 DRV+EVG/c/TAF/FTC 2.9 3 2 1
3 DRV/r+DTG/TDF/3TC 2.9 3 3 1
3 DRV/c+DOR/TDF/3TC 2.95 3 2 1
3 RPV+DRV/c/TAF/FTC 2.95 3 2 1
3 DTG+DOR+TAF/FTC 2.96 3 3 1
3 DTG+DOR+TDF/FTC 2.96 3 3 1
3 DOR+EVG/c/TAF/FTC 3.05 3 2 1
3 DOR+EVG/c/TDF/FTC 3.05 3 2 1
3 DRV/c+RPV/TDF/FTC 3.05 3 2 1
3 DTG+DRV/c+TDF/FTC 3.05 3 3 1
3 DRV/r+DOR/TDF/3TC 3.15 3 3 1
3 DRV/c+DOR+TDF/FTC 3.15 3 3 1
3 RAL+DRV/c/TAF/FTC 3.2 3 3 1
3 DRV/r+DOR+TAF/FTC 3.25 3 4 1
3 DTG+DRV/r+DOR 3.26 3 4 1
3 DRV/r+RPV/TAF/FTC 3.3 3 3 1
3 DRV/r+DTG/RPV 3.31 3 3 1
3 RPV+BIC/TAF/FTC 3.35 3 2 1
3 DRV/r+DOR+TDF/FTC 3.35 3 4 1
3 DTG+DRV/r+TDF/FTC 3.35 3 4 1
3 DRV/r+EFV/TDF/FTC 3.4 3 3 1
3 DRV/r+RPV/TDF/FTC 3.4 3 3 1
3 RAL+DOR/TDF/3TC 3.55 3 3 1
3 RAL+DRV/c+TDF/FTC 3.6 3 4 1
3 RPV+EVG/c/TAF/FTC 3.65 3 2 1
3 RAL+RPV/TAF/FTC 3.65 3 3 1
3 RAL+EFV/TDF/FTC 3.65 3 3 1
3 RAL+DRV/c+DOR 3.65 3 4 1
3 RAL+DOR+TAF/FTC 3.65 3 4 1
3 RAL+DRV/r+TAF/FTC 3.7 3 5 1
3 RAL+RPV/TDF/FTC 3.75 3 3 1
3 RAL+DOR+TDF/FTC 3.75 3 4 1
3 RAL+DRV/r+TDF/FTC 3.9 3 5 1
3 RAL+DRV/c 3.95 2 3 1
3 RAL+DRV/r+DOR 3.95 3 5 1
4 CAB/RPV 4.1 2 0 0.03
4 RAL+DRV/c+RPV 4.1 3 4 1
4 DRV/c+DOR 4.2 2 2 1
4 RAL+DRV/r 4.25 2 4 1
4 DRV/r+EFV+TAF/FTC 4.25 3 4 1
4 DRV/r+ETR+TAF/FTC 4.3 3 5 2
4 DRV/r+DOR 4.4 2 3 1
4 DRV/r+ETR+TDF/FTC 4.4 3 5 2
4 RAL+EFV+TAF/FTC 4.5 3 4 1
4 DTG+EFV/TDF/FTC 4.55 3 3 2
4 RAL+DRV/r+RPV 4.55 3 5 1
4 EVG/c/TAF/FTC 4.75 2 1 1
4 EVG/c/TDF/FTC 4.85 2 1 1
4 RAL+TAF/FTC 4.85 2 3 1
4 DTG+3TC/AZT 4.95 2 3 2
4 RAL+TDF/FTC 4.95 2 3 1
4 RAL+DRV/r+EFV 4.95 3 5 1
4 DTG+DOR 4.96 2 2 1
4 DTG/RPV 5.01 2 1 1
4 DTG+AZT+FTC 5.15 2 4 2
4 DTG+DOR+DRV/c/TAF/FTC 5.21 4 3 1
4 EFV+DTG/TDF/3TC 5.3 3 3 2
4 DRV/c+DOR+BIC/TAF/FTC 5.3 4 3 1
4 DTG+DRV/c+DOR/TDF/3TC 5.31 4 3 1
4 DTG+RPV+DRV/c/TAF/FTC 5.31 4 3 1
4 DRV/c+RPV 5.4 2 2 1
4 DRV/r+EFV 5.4 2 3 1
4 DRV/c+RPV+BIC/TAF/FTC 5.4 4 3 1
4 DRV/c+RPV+DTG/TDF/3TC 5.41 4 3 1
4 DTG+DRV/c+RPV/TDF/FTC 5.41 4 3 1
4 FTR+DTG/TDF/3TC 5.5 3 3 2
4 FTR+BIC/TAF/FTC 5.5 3 3 2
4 DTG+EFV+TAF/FTC 5.5 3 4 2
4 DTG+DRV/r+ETR 5.5 3 6 2
4 DRV/r+DOR+BIC/TAF/FTC 5.5 4 4 1
4 DTG+DRV/c+DOR+TDF/FTC 5.51 4 4 1
4 RAL+ETR+TAF/FTC 5.55 3 5 2
4 DRV+DOR+EVG/c/TAF/FTC 5.6 4 3 1
4 DTG+DRV/r+DOR/TDF/3TC 5.61 4 4 1
4 RAL+ETR+TDF/FTC 5.65 3 5 2
4 DTG+FTR+TAF/FTC 5.7 3 4 2
4 DTG+FTR+TDF/FTC 5.7 3 4 2
4 DTG+DRV/r+DOR+TAF/FTC 5.71 4 5 1
4 DRV/r+RPV 5.75 2 3 1
4 FTR+DRV/c/TAF/FTC 5.75 3 3 2
4 DRV/r+RPV+BIC/TAF/FTC 5.75 4 4 1
4 DTG+DRV/r+RPV/TAF/FTC 5.76 4 4 1
4 FTR+EVG/c/TAF/FTC 5.8 3 3 2
4 FTR+EVG/c/TDF/FTC 5.8 3 3 2
4 DTG+DRV/r+DOR+TDF/FTC 5.81 4 5 1
4 DRV/r+RPV+DTG/TDF/3TC 5.86 4 4 1
4 DTG+DRV/r+RPV/TDF/FTC 5.86 4 4 1
4 DTG+DRV/c+3TC/AZT 5.9 3 4 2
4 DTG+FTR+DRV/c 5.9 3 4 2
4 RAL+DOR+DRV/c/TAF/FTC 5.9 4 4 1
4 DRV/c+3TC/AZT 5.95 2 3 2
4 DTG+DRV/r+EFV 5.95 3 5 2
5 FTR+DRV/r+TAF/FTC 6 3 5 2
5 RAL+DRV/r+ETR 6 3 6 2
5 FTR+DRV/c+TDF/FTC 6.05 3 4 2
5 DTG+FTR+DRV/r 6.05 3 5 2
5 DTG+DRV/c+AZT+FTC 6.1 3 5 2
5 FTR+DRV/r+TDF/FTC 6.1 3 5 2
5 DTG+FTR+DRV/c/TAF/FTC 6.1 4 4 2
5 RAL+DRV/c+DOR/TDF/3TC 6.1 4 4 1
5 RAL+RPV+DRV/c/TAF/FTC 6.1 4 4 1
5 DRV/r+3TC/AZT 6.15 2 4 2
5 DRV/c+AZT+FTC 6.15 2 4 2
5 DTG+IBA+DRV/c/TAF/FTC 6.15 4 2 1
5 DTG+DOR+3TC/AZT 6.16 3 4 2
5 DTG+DRV/r+3TC/AZT 6.2 3 5 2
5 DRV+RPV+EVG/c/TAF/FTC 6.2 4 3 1
5 FTR+DRV/c+DTG/TDF/3TC 6.2 4 4 2
5 FTR+DRV/c+BIC/TAF/FTC 6.2 4 4 2
5 IBA+DRV/c/TAF/FTC 6.25 3 1 1
5 IBA+DTG/TDF/3TC 6.25 3 1 1
5 IBA+BIC/TAF/FTC 6.25 3 1 1
5 LEN+DTG/TDF/3TC 6.25 3 1 1
5 LEN+BIC/TAF/FTC 6.25 3 1 1
5 DTG+LEN+TAF/FTC 6.25 3 2 1
5 DTG+LEN+TDF/FTC 6.25 3 2 1
5 DTG+IBA+TAF/FTC 6.25 3 2 1
5 DTG+IBA+TDF/FTC 6.25 3 2 1
5 DRV/c+DOR+3TC/AZT 6.25 3 4 2
5 IBA+DRV/c+DTG/TDF/3TC 6.25 4 2 1
5 IBA+DRV/c+BIC/TAF/FTC 6.25 4 2 1
5 FTR+DRV+EVG/c/TAF/FTC 6.25 4 4 2
5 FTR+DRV/r+BIC/TAF/FTC 6.25 4 5 2
5 AZT+FTC+DTG/RPV 6.26 3 4 2
5 DTG+RPV+3TC/AZT 6.26 3 4 2
5 RAL+DRV/c+RPV/TDF/FTC 6.3 4 4 1
5 RAL+DRV/c+DOR+TDF/FTC 6.3 4 5 1
5 DRV/r+ETR 6.35 2 4 2
5 DRV/r+AZT+FTC 6.35 2 5 2
5 IBA+DRV/c+TDF/FTC 6.35 3 2 1
5 FTR+DRV/r+DTG/TDF/3TC 6.35 4 5 2
5 FTR+DTG/RPV 6.36 3 3 2
5 DTG+FTR+DOR 6.36 3 4 2
5 DTG+DOR+AZT+FTC 6.36 3 5 2
5 RAL+FTR+TAF/FTC 6.4 3 5 2
5 DTG+DRV/r+AZT+FTC 6.4 3 6 2
5 DTG+FTR+DRV/c+TDF/FTC 6.4 4 5 2
5 RAL+DRV/r+DOR/TDF/3TC 6.4 4 5 1
5 RAL+DRV/r+DOR+TAF/FTC 6.4 4 6 1
5 IBA+DRV/r+TAF/FTC 6.45 3 3 1
5 DRV/r+DOR+3TC/AZT 6.45 3 5 2
5 DRV/c+DOR+AZT+FTC 6.45 3 5 2
5 DTG+IBA+DRV/c+TDF/FTC 6.45 4 3 1
5 IBA+DRV/r+BIC/TAF/FTC 6.45 4 3 1
5 DTG+FTR+DRV/r+TAF/FTC 6.45 4 6 2
5 IBA+DRV/c+DTG/RPV 6.46 4 2 1
5 FTR+DRV/c+DTG/RPV 6.46 4 4 2
5 DTG+FTR+DRV/c+DOR 6.46 4 5 2
5 DTG+IBA+DRV/c 6.5 3 2 1
5 DTG+LEN+DRV/c 6.5 3 2 1
5 RAL+FTR+TDF/FTC 6.5 3 5 2
5 IBA+EVG/c/TAF/FTC 6.55 3 1 1
5 IBA+EVG/c/TDF/FTC 6.55 3 1 1
5 DTG+LEN+DRV/r 6.55 3 3 1
5 IBA+DRV/r+TDF/FTC 6.55 3 3 1
5 IBA+DRV+EVG/c/TAF/FTC 6.55 4 2 1
5 IBA+DRV/r+DTG/TDF/3TC 6.55 4 3 1
5 RAL+DRV/r+RPV/TAF/FTC 6.55 4 5 1
5 DTG+FTR+DRV/r+TDF/FTC 6.55 4 6 2
5 DTG+IBA+DRV/c+DOR 6.56 4 3 1
5 DOR/TDF/3TC 6.6 2 1 1
5 DOR+TAF/FTC 6.6 2 2 1
5 DRV/c+RPV+3TC/AZT 6.6 3 4 2
5 RAL+DRV/c+3TC/AZT 6.6 3 5 2
5 RAL+FTR+DRV/c 6.6 3 5 2
5 RAL+DRV/r+DOR+TDF/FTC 6.6 4 6 1
5 DTG+FTR+DRV/r+DOR 6.61 4 6 2
5 DRV/r+DOR+AZT+FTC 6.65 3 6 2
5 DTG+IBA+DRV/r+TAF/FTC 6.65 4 4 1
5 RAL+DRV/r+EFV/TDF/FTC 6.65 4 5 1
5 DTG+FTR 6.69 2 3 2
5 RAL+DOR 6.7 2 3 1
5 LEN+DRV/r+TAF/FTC 6.7 3 3 1
5 FTR+DRV/c+DOR 6.7 3 4 2
5 DTG+IBA+DOR 6.71 3 2 1
5 LEN+DRV/c/TAF/FTC 6.75 3 1 1
5 FTR+DRV/r+DOR 6.75 3 5 2
5 RAL+FTR+DRV/r 6.75 3 6 2
5 DTG+IBA+DRV/r+TDF/FTC 6.75 4 4 1
5 RAL+DRV/r+RPV/TDF/FTC 6.75 4 5 1
5 FTR+DRV/r+DTG/RPV 6.76 4 5 2
5 LEN+EVG/c/TAF/FTC 6.8 3 1 1
5 LEN+EVG/c/TDF/FTC 6.8 3 1 1
5 IBA+DRV/c+DOR 6.8 3 2 1
5 DTG+IBA+DRV/r 6.8 3 3 1
5 LEN+DRV/r+TDF/FTC 6.8 3 3 1
5 DRV/c+RPV+AZT+FTC 6.8 3 5 2
5 RAL+DRV/c+AZT+FTC 6.8 3 6 2
5 RAL+FTR+DRV/c/TAF/FTC 6.8 4 5 2
5 IBA+DTG/RPV 6.81 3 1 1
5 LEN+DRV/c+TDF/FTC 6.85 3 2 1
5 RAL+DOR+3TC/AZT 6.85 3 5 2
5 RAL+IBA+DRV/c/TAF/FTC 6.85 4 3 1
5 DTG+IBA+DRV/r+DOR 6.86 4 4 1
5 EFV/TDF/FTC 6.9 2 1 1
5 RAL+DRV/r+3TC/AZT 6.9 3 6 2
5 DTG+LEN+DRV/c/TAF/FTC 6.9 4 2 1
5 DTG+LEN+IBA+DOR 6.91 4 2 1
5 IBA+DRV/r+DTG/RPV 6.91 4 3 1
5 FTR+DRV/c 6.94 2 3 2
5 RAL+LEN+TAF/FTC 6.95 3 3 1
5 RAL+IBA+TAF/FTC 6.95 3 3 1
5 DRV/r+RPV+3TC/AZT 6.95 3 5 2
5 LEN+DRV/r+BIC/TAF/FTC 6.95 4 3 1
5 DTG+LEN+DOR 6.96 3 2 1
5 FTR+DRV/r 6.99 2 4 2
5 IBA+DRV/r+DOR 7 3 3 1
5 DRV/r+ETR+3TC/AZT 7 3 6 2
5 DTG+LEN+IBA+DRV/c 7 4 2 1
5 LEN+DRV/c+DTG/TDF/3TC 7 4 2 1
5 LEN+DRV/c+BIC/TAF/FTC 7 4 2 1
5 LEN+IBA+DTG/RPV 7.01 4 1 1
5 RAL+LEN+TDF/FTC 7.05 3 3 1
5 RAL+IBA+TDF/FTC 7.05 3 3 1
5 RAL+FTR+DOR 7.05 3 5 2
5 RAL+DOR+AZT+FTC 7.05 3 6 2
5 LEN+DRV+EVG/c/TAF/FTC 7.05 4 2 1
5 DTG+LEN+IBA+DRV/r 7.05 4 3 1
5 LEN+DRV/r+DTG/TDF/3TC 7.05 4 3 1
5 LEN+DTG/RPV 7.06 3 1 1
5 RAL+DRV/r+AZT+FTC 7.1 3 7 2
5 DTG+IBA 7.15 2 1 1
5 IBA+DRV/c 7.15 2 1 1
5 IBA+DRV/r 7.15 2 2 1
5 RAL+RPV 7.15 2 3 1
5 IBA+DRV/c+RPV 7.15 3 2 1
5 FTR+DRV/c+RPV 7.15 3 4 2
5 DRV/r+RPV+AZT+FTC 7.15 3 6 2
5 DTG+LEN+DRV/r+TAF/FTC 7.15 4 4 1
5 RAL+FTR+DRV/c+DOR 7.15 4 6 2
5 RAL+FTR+DRV/r+TAF/FTC 7.15 4 7 2
5 RAL+IBA+DRV/c 7.2 3 3 1
5 RAL+LEN+DRV/c 7.2 3 3 1
5 DRV/r+ETR+AZT+FTC 7.2 3 7 2
5 DTG+LEN+DRV/c+TDF/FTC 7.2 4 3 1
5 RAL+FTR+DRV/c+TDF/FTC 7.2 4 6 2
5 LEN+DRV/c+DTG/RPV 7.21 4 2 1
5 DTG+LEN 7.24 2 1 1
5 RAL+LEN+DRV/r 7.25 3 4 1
5 DTG+LEN+DRV/r+TDF/FTC 7.25 4 4 1
5 RAL+IBA+DRV/c+DOR 7.25 4 4 1
5 RAL+IBA+DRV/c+TDF/FTC 7.25 4 4 1
5 RAL+RPV+3TC/AZT 7.3 3 5 2
5 RAL+FTR+DRV/r+DOR 7.3 4 7 2
5 DTG+LEN+DRV/c+DOR 7.31 4 3 1
5 FTR+DRV/r+RPV 7.35 3 5 2
5 RAL+IBA+DRV/r+TAF/FTC 7.35 4 5 1
5 RAL+FTR+DRV/r+TDF/FTC 7.35 4 7 2
5 DTG+LEN+DRV/r+DOR 7.36 4 4 1
5 RAL+IBA+DOR 7.4 3 3 1
5 FTR+DRV/r+ETR 7.4 3 6 2
5 RAL+DRV/r+EFV+TAF/FTC 7.4 4 6 1
5 LEN+DRV/r+DTG/RPV 7.41 4 3 1
5 DRV/r+EFV+3TC/AZT 7.45 3 5 2
5 LEN+IBA+DRV/r+DOR 7.45 4 3 1
5 LEN+DRV/r 7.49 2 2 1
5 IBA+DRV/r+RPV 7.5 3 3 1
5 LEN+DRV/r+DOR 7.5 3 3 1
5 RAL+IBA+DRV/r 7.5 3 4 1
5 RAL+RPV+AZT+FTC 7.5 3 6 2
5 LEN+IBA+DRV/c+DOR 7.5 4 2 1
5 DTG+EFV 7.55 2 3 2
5 RAL+EFV 7.55 2 3 1
5 LEN+DRV/c+DOR 7.55 3 2 1
5 DTG+DRV/r+EFV/TDF/FTC 7.55 4 5 2
5 RAL+IBA+DRV/r+DOR 7.55 4 5 1
5 RAL+IBA+DRV/r+TDF/FTC 7.55 4 5 1
5 FTR+IBA+DTG/RPV 7.56 4 3 2
5 DTG+FTR+IBA+DOR 7.56 4 4 2
5 RAL+FTR+RPV 7.6 3 5 2
5 LEN+RAL+DRV/c/TAF/FTC 7.6 4 3 1
5 LEN+RAL+IBA+DOR 7.6 4 3 1
5 EFV+TAF/FTC 7.65 2 2 1
5 LEN+RAL+DOR 7.65 3 3 1
5 DRV/r+EFV+AZT+FTC 7.65 3 6 2
5 DTG+FTR+IBA+DRV/c 7.65 4 4 2
5 RPV/TAF/FTC 7.7 2 1 1
5 RAL+EFV+3TC/AZT 7.7 3 5 2
5 LEN+RAL+IBA+DRV/c 7.7 4 3 1
5 RAL+IBA+DRV/c+RPV 7.7 4 4 1
5 RAL+FTR+DRV/c+RPV 7.7 4 6 2
5 LEN+DRV/c 7.74 2 1 1
5 FTR+DRV/r+EFV 7.75 3 5 2
5 LEN+RAL+IBA+DRV/r 7.75 4 4 1
5 DTG+FTR+IBA+DRV/r 7.8 4 5 2
5 RAL+IBA+RPV 7.85 3 3 1
5 LEN+IBA+DRV/c+RPV 7.85 4 2 1
5 LEN+RAL+DRV/r+TAF/FTC 7.85 4 5 1
5 DRV/r+ETR+DTG/TDF/3TC 7.85 4 6 2
5 LEN+DRV/c+RPV 7.9 3 2 1
5 RAL+FTR+EFV 7.9 3 5 2
5 RAL+EFV+AZT+FTC 7.9 3 6 2
5 FTR+IBA+DRV/c+DOR 7.9 4 4 2
5 LEN+IBA+DRV/r+RPV 7.95 4 3 1
5 FTR+IBA+DRV/r+DOR 7.95 4 5 2
5 DTG+DRV/r+ETR+TAF/FTC 7.95 4 7 2
5 DOR+TDF/FTC 8 2 2 1
5 IBA+DRV/r+EFV 8 3 3 1
5 LEN+DRV/r+RPV 8 3 3 1
5 LEN+RAL+DRV/c+DOR 8 4 4 1
5 LEN+RAL+DRV/c+TDF/FTC 8 4 4 1
5 RAL+FTR+DRV/r+RPV 8 4 7 2
5 IBA+DRV/r+ETR 8.05 3 4 2
5 LEN+RAL+IBA+RPV 8.05 4 3 1
5 LEN+RAL+DRV/r+DOR 8.05 4 5 1
5 LEN+RAL+DRV/r+TDF/FTC 8.05 4 5 1
5 DTG+DRV/r+ETR+TDF/FTC 8.05 4 7 2
5 LEN+FTR+DTG/RPV 8.06 4 3 2
5 DTG+LEN+FTR+DOR 8.06 4 4 2
5 LEN+RAL+RPV 8.1 3 3 1
5 RAL+IBA+DRV/r+RPV 8.15 4 5 1
5 RPV/TDF/FTC 8.2 2 1 1
5 DTG+EFV+3TC/AZT 8.2 3 5 2
5 RAL+IBA+EFV 8.25 3 3 1
5 RAL+ETR+3TC/AZT 8.25 3 6 2
5 RAL+FTR+IBA+DOR 8.25 4 5 2
5 DRV/r+EFV+DTG/TDF/3TC 8.3 4 5 2
5 DTG+LEN+FTR+DRV/r 8.3 4 5 2
5 RAL+FTR+DRV/r+EFV 8.3 4 7 2
5 DTG+FTR+3TC/AZT 8.35 3 5 2
5 FTR+IBA+DRV/c+RPV 8.35 4 4 2
5 RAL+FTR+IBA+DRV/c 8.35 4 5 2
5 RAL+FTR 8.39 2 4 2
5 DTG+FTR+EFV 8.4 3 5 2
5 DTG+EFV+AZT+FTC 8.4 3 6 2
5 DTG+LEN+FTR+DRV/c 8.4 4 4 2
5 DTG+DRV/r+EFV+TAF/FTC 8.4 4 6 2
5 RAL+ETR+AZT+FTC 8.45 3 7 2
5 LEN+RAL+DRV/c+RPV 8.45 4 4 1
5 RAL+DRV/r+ETR+TAF/FTC 8.45 4 7 2
5 DTG+FTR+DRV/r+ETR 8.45 4 8 2
5 RAL+FTR+IBA+DRV/r 8.5 4 6 2
5 DTG+FTR+AZT+FTC 8.55 3 6 2
5 RAL+FTR+ETR 8.55 3 6 2
5 FTR+IBA+DRV/r+RPV 8.55 4 5 2
5 RAL+IBA+DRV/r+EFV 8.55 4 5 1
5 RAL+ETR 8.6 2 4 2
5 FTR+DRV/c+3TC/AZT 8.6 3 5 2
5 FTR+IBA+DRV/r+ETR 8.6 4 6 2
5 DTG+DRV/c+DOR+3TC/AZT 8.61 4 5 2
5 RAL+IBA 8.65 2 2 1
5 RAL+3TC/AZT 8.65 2 4 2
5 FTR+DRV/r+3TC/AZT 8.65 3 6 2
5 LEN+RAL+DRV/r+RPV 8.65 4 5 1
5 RAL+DRV/r+ETR+TDF/FTC 8.65 4 7 2
5 LEN+FTR+DRV/r+DOR 8.7 4 5 2
5 DRV/c+AZT+FTC+DTG/RPV 8.71 4 5 2
5 DTG+DRV/c+RPV+3TC/AZT 8.71 4 5 2
5 RAL+LEN 8.74 2 2 1
5 LEN+RAL+FTR+DOR 8.75 4 5 2
5 FTR+DRV/c+AZT+FTC 8.8 3 6 2
5 RAL+FTR+IBA+RPV 8.8 4 5 2
5 DTG+FTR+DRV/r+EFV 8.8 4 7 2
5 DTG+DRV/c+DOR+AZT+FTC 8.81 4 6 2
5 RAL+AZT+FTC 8.85 2 5 2
5 FTR+DRV/r+AZT+FTC 8.85 3 7 2
5 ETR+TAF/FTC 8.9 2 3 2
5 ETR+TDF/FTC 8.9 2 3 2
5 LEN+FTR+DRV/c+DOR 8.9 4 4 2
5 DTG+DRV/r+DOR+3TC/AZT 8.91 4 6 2
5 FTR+IBA+DRV/r+EFV 8.95 4 5 2
5 DTG+FTR+DRV/c+3TC/AZT 8.95 4 6 2
5 RAL+FTR+DRV/r+ETR 8.95 4 8 2
5 LEN+RAL+FTR+DRV/r 9 4 6 2
5 RAL+FTR+3TC/AZT 9.05 3 6 2
5 LEN+RAL+FTR+DRV/c 9.1 4 5 2
5 RAL+FTR+IBA+EFV 9.1 4 5 2
5 DTG+IBA+DRV/r+ETR 9.1 4 6 2
5 DTG+FTR+DRV/r+3TC/AZT 9.1 4 7 2
5 DTG+DRV/r+DOR+AZT+FTC 9.11 4 7 2
5 DTG+FTR+DRV/c+AZT+FTC 9.15 4 7 2
5 DRV/r+AZT+FTC+DTG/RPV 9.16 4 6 2
5 DTG+DRV/r+RPV+3TC/AZT 9.16 4 6 2
5 DTG+LEN+3TC/AZT 9.2 3 3 2
5 DTG+IBA+EFV 9.25 3 3 2
5 RAL+FTR+AZT+FTC 9.25 3 7 2
5 RAL+IBA+ETR 9.3 3 4 2
5 LEN+FTR+DRV/r+RPV 9.3 4 5 2
5 LEN+RAL+FTR+RPV 9.3 4 5 2
5 RAL+DRV/c+DOR+3TC/AZT 9.3 4 6 2
5 DTG+FTR+DRV/r+AZT+FTC 9.3 4 8 2
5 LEN+FTR+DRV/c+RPV 9.35 4 4 2
5 DTG+LEN+AZT+FTC 9.4 3 4 2
5 DTG+IBA+3TC/AZT 9.45 3 3 2
5 IBA+DRV/c+3TC/AZT 9.45 3 3 2
5 RAL+DRV/c+DOR+AZT+FTC 9.5 4 7 2
5 DTG+IBA+DRV/c+3TC/AZT 9.55 4 4 2
5 DTG+IBA+DRV/r+EFV 9.55 4 5 2
5 DTG+FTR+IBA+EFV 9.6 4 5 2
5 RAL+IBA+DRV/r+ETR 9.6 4 6 2
5 RAL+DRV/r+DOR+3TC/AZT 9.6 4 7 2
5 DTG+IBA+AZT+FTC 9.65 3 4 2
5 IBA+DRV/r+3TC/AZT 9.65 3 4 2
5 IBA+DRV/c+AZT+FTC 9.65 3 4 2
5 LEN+DRV/r+3TC/AZT 9.65 3 4 2
5 RAL+FTR+DRV/c+3TC/AZT 9.65 4 7 2
5 LEN+DRV/c+3TC/AZT 9.7 3 3 2
5 DTG+IBA+DRV/c+AZT+FTC 9.75 4 5 2
5 RAL+DRV/c+RPV+3TC/AZT 9.75 4 6 2
5 RAL+FTR+IBA+ETR 9.75 4 6 2
5 RAL+DRV/r+DOR+AZT+FTC 9.8 4 8 2
5 RAL+FTR+DRV/r+3TC/AZT 9.8 4 8 2
5 IBA+DRV/r+AZT+FTC 9.85 3 5 2
5 LEN+DRV/r+AZT+FTC 9.85 3 5 2
5 DTG+IBA+DRV/r+3TC/AZT 9.85 4 5 2
5 RAL+FTR+DRV/c+AZT+FTC 9.85 4 8 2
5 LEN+DRV/c+AZT+FTC 9.9 3 4 2
5 RAL+LEN+3TC/AZT 9.9 3 4 2
5 RAL+DRV/c+RPV+AZT+FTC 9.95 4 7 2
5 RAL+FTR+DRV/r+AZT+FTC 10 4 9 2
5 DTG+LEN+DRV/c+3TC/AZT 10.05 4 4 2
5 DTG+IBA+DRV/r+AZT+FTC 10.05 4 6 2
5 RAL+LEN+AZT+FTC 10.1 3 5 2
5 DTG+LEN+DRV/r+3TC/AZT 10.1 4 5 2
5 RAL+IBA+3TC/AZT 10.15 3 4 2
5 LEN+IBA+DRV/r+ETR 10.15 4 4 2
5 LEN+DRV/r+ETR 10.2 3 4 2
5 RAL+DRV/r+RPV+3TC/AZT 10.2 4 7 2
5 DTG+LEN+DRV/c+AZT+FTC 10.25 4 5 2
5 RAL+IBA+DRV/c+3TC/AZT 10.25 4 5 2
5 DTG+LEN+DRV/r+AZT+FTC 10.3 4 6 2
5 RAL+IBA+AZT+FTC 10.35 3 5 2
5 RAL+DRV/r+RPV+AZT+FTC 10.4 4 8 2
5 RAL+IBA+DRV/c+AZT+FTC 10.45 4 6 2
5 RAL+IBA+DRV/r+3TC/AZT 10.55 4 6 2
5 RAL+DRV/r+EFV+3TC/AZT 10.6 4 7 2
5 DTG+DRV/r+ETR+3TC/AZT 10.65 4 8 2
5 LEN+RAL+DRV/c+3TC/AZT 10.75 4 5 2
5 RAL+IBA+DRV/r+AZT+FTC 10.75 4 7 2
5 LEN+RAL+DRV/r+3TC/AZT 10.8 4 6 2
5 RAL+DRV/r+EFV+AZT+FTC 10.8 4 8 2
5 DTG+DRV/r+ETR+AZT+FTC 10.85 4 9 2
5 LEN+RAL+DRV/c+AZT+FTC 10.95 4 6 2
5 LEN+FTR+DRV/r+ETR 11 4 6 2
5 LEN+RAL+DRV/r+AZT+FTC 11 4 7 2
5 DTG+DRV/r+EFV+3TC/AZT 11.1 4 7 2
5 LEN+RAL+IBA+ETR 11.15 4 4 2
5 RAL+DRV/r+ETR+3TC/AZT 11.15 4 8 2
5 DOR+3TC/AZT 11.2 2 3 2
5 LEN+RAL+ETR 11.2 3 4 2
5 DTG+LEN+DRV/r+ETR 11.25 4 6 2
5 DTG+DRV/r+EFV+AZT+FTC 11.3 4 8 2
5 RAL+DRV/r+ETR+AZT+FTC 11.35 4 9 2
5 DOR+AZT+FTC 11.4 2 4 2
5 ETR+3TC/AZT 11.6 2 4 2
5 LEN+RAL+DRV/r+ETR 11.75 4 6 2
5 ETR+AZT+FTC 11.8 2 5 2
5 LEN+RAL+FTR+ETR 11.9 4 6 2
5 EFV+3TC/AZT 12.05 2 3 2
5 EFV+AZT+FTC 12.25 2 4 2
5 RPV+3TC/AZT 12.55 2 3 2
5 RPV+AZT+FTC 12.75 2 4 2

Report

Preferred regimen based on the HIV-ASSIST algorithm: BIC/TAF/FTC

BIC/TAF/FTC had the lowest weighted score (0.75) among all regimens HIV-ASSIST evaluated. In general, lower HIV-ASSIST weighted scores are considered preferable with respect to achieving viral suppression and maximizing tolerability. Your patient may have other considerations we did not factor and this report should not be considered a guarantee of likely success with this patient. Please use clinical judgement in making final ARV selections. Other regimens you may wish to consider are listed below. A full list of ARV regimens analyzed by the HIV-ASSIST algorithm can be found by clicking the Expert Tab above.

Score Code Regimen Weighted Score Active Drugs Total Pills Frequency (x/day)
1 BIC/TAF/FTC 0.75 2 1 1

The rationale behind why this regimen was chosen by our algorithm as the most appropriate is shown below:

Other highly ranked regimens

Other highly ranked regimens based on the HIV-ASSIST algorithm are shown below. For full details on these regimens, please click on the Expert Tab above.

Score Code Regimen Weighted Score Active Drugs Total Pills Frequency (x/day)
1 DTG/TDF/3TC 0.75 2 1 1
1 DTG+TAF/FTC 0.75 2 2 1
1 DTG+TDF/FTC 0.75 2 2 1
1 DRV/c/TAF/FTC [Current regimen] 1.25 2 1 1

Mutations

Based on the Stanford Database, we assign penalties to various regimens based on inputted (i.e., genotypic) and assumed archived mutations. We consider drugs with summed mutation scores between 10 and 29 to have low-level resistance, scores between 30 and 59 to have intermediate-level resistance, and scores above 60 to have high-level resistance.

* signifies an assumed archived mutation based on prior treatment experience.
NRTI Mutation(s) 3TC FTC ABC TAF TDF AZT D4T DDI
M184V* 60 60 15 -10 -10 -10 -10 10
Total 60 60 15 -10 -10 -10 -10 10
NNRTI Mutation(s) EFV ETR RPV NVP DOR
Total 0 0 0 0 0
PI Mutation(s) LPVr FPVr TPVr SQVr IDVr NFV ATVr ATVc ATV DRV DRVr DRVc
Total 0 0 0 0 0 0 0 0 0 0 0 0
INSTI Mutation(s) RAL EVGc DTG BIC CAB
Total 0 0 0 0 0
EI Mutation(s) MVC IBA FOS
Total 0 0 0
CI Mutation(s) LEN
Total 0

Comorbidities, Side Effects, and Pregnancy Interactions

HIV-ASSIST incorporates a mathematical penalty into our algorithms for ARVs that are less preferred due to comorbidities or side-effects, based on recommendations from DHHS guidelines and HIV-ASSIST clinician and pharmacist expertise. In general, higher penalties suggest that the listed ARV is less favored in the presence of the stated comorbidity or side effect.

Co-medication Interactions

We have identified the following possible drug interactions which HIV-ASSIST factors into ARV regimen selection, based on recommendations from DHHS guidelines, University of Liverpool HIV Drug Interaction Checker, and HIV-ASSIST clinician and pharmacist expertise. Penalties less than 1.0 are typically those representing minor interactions that can be mediated by dosage adjustments, whereas a penalty of 2.0 represents medically contraindicated ARVs.

Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration of rifampicin-based TB treatment (rifampicin 450 mg in patients <50 kg or 600 mg in patients >50 kg, once daily; with isoniazid, pyrazinamide and ethambutol) and efavirenz/tenofovir-DF/emtricitabine (600/245/200 mg, once daily) was studied in 21 TB-HIV coinfected patients in a crossover study. Coadministration increased efavirenz AUC, Cmax and Cmin by 8%, 2% and 11%, respectively; tenofovir AUC and Cmin increased by 13% and 9% respectively, while Cmax decreased by 2%; emtricitabine AUC and Cmin increased by 5% and 26% respectively, while Cmax decreased by 3%. Bioequivalence for the TB drugs was suggested for Cmax when administered with and without efavirenz/tenofovir/emtricitabine (coadministration decreased rifampicin by 14%, decreased isoniazid by 5%, increased pyrazinamide by 14% and had no effect on ethambutol). The combination was tolerated well by Tanzanian TB–HIV-coinfected patients. The authors conclude that coadministration of the standard first-line TB treatment regimen with efavirenz, tenofovir and emtricitabine does not alter pharmacokinetic parameters. Efavirenz, tenofovir and emtricitabine combined with first-line tuberculosis treatment in tuberculosis-HIV-coinfected Tanzanian patients: a pharmacokinetic and safety study. Semvua H, Mtabho C, Fillekes Q, et al. Antivir Ther, 2013, 18(1): 105-113., Summary:Coadministration of emtricitabine and isoniazid alone has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine. Coadministration of TB treatment containing isoniazid (with rifampicin, ethambutol and pyrazinamide) and emtricitabine (with tenofovir-DF and efavirenz) increased emtricitabine AUC and Cmin by 5% and 26% and decreased Cmax by 3%; isoniazid Cmax decreased by 5%.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine. Emtricitabine and tenofovir alafenamide do not interfere with this metabolic pathway. Dose Descovy according to the concomitant antiretroviral.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration of rifampicin-based TB treatment (rifampicin 450 mg in patients <50 kg or 600 mg in patients >50 kg, once daily; with isoniazid, pyrazinamide and ethambutol) and efavirenz/tenofovir-DF/emtricitabine (600/245/200 mg, once daily) was studied in 21 TB-HIV coinfected patients in a crossover study. Coadministration increased efavirenz AUC, Cmax and Cmin by 8%, 2% and 11%, respectively; tenofovir AUC and Cmin increased by 13% and 9% respectively, while Cmax decreased by 2%; emtricitabine AUC and Cmin increased by 5% and 26% respectively, while Cmax decreased by 3%. Bioequivalence for the TB drugs was suggested for Cmax when administered with and without efavirenz/tenofovir/emtricitabine (coadministration decreased rifampicin by 14%, decreased isoniazid by 5%, increased pyrazinamide by 14% and had no effect on ethambutol). The combination was tolerated well by Tanzanian TB–HIV-coinfected patients. The authors conclude that coadministration of the standard first-line TB treatment regimen with efavirenz, tenofovir and emtricitabine does not alter pharmacokinetic parameters. Efavirenz, tenofovir and emtricitabine combined with first-line tuberculosis treatment in tuberculosis-HIV-coinfected Tanzanian patients: a pharmacokinetic and safety study. Semvua H, Mtabho C, Fillekes Q, et al. Antivir Ther, 2013, 18(1): 105-113., Summary:Coadministration of tenofovir-DF and isoniazid alone has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine. Coadministration of TB treatment containing isoniazid (with rifampicin, ethambutol and pyrazinamide) and tenofovir-DF (with emtricitabine and efavirenz) increased tenofovir AUC and Cmin by 13% and 9% and decreased Cmax by 2%; isoniazid Cmax decreased by 5%.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine.
Penalty:
0
Liverpool Interaction Status:
Amber/Moderate: Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
There may be an increased risk of distal sensory neuropathy when isoniazid is used in patients taking stavudine (d4T). Isoniazid Summary of Product Characteristics, UCB Pharma Ltd, April 2007., Summary:There may be an increased risk of distal sensory neuropathy when isoniazid is used with stavudine (d4T).
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Moderate Quality of Evidence)
Liverpool Notes:
The effect of the antacid in didanosine tables on isoniazid pharmacokinetics was investigated in 12 HIV-negative subjects. Isoniazid pharmacokinetics were determined following administration of a single dose of isoniazid (300 mg) alone and in combination with a single dose of didanosine placebo tablets (2 tablets containing antacid component only) and were not significantly different when administered alone or in combination with antacids. Effect of antacids in didanosine tablet on bioavailability of isoniazid. Gallicano K, et al. Antimicrob Agents Chemother, 1994, 38:894-897. , Summary:No significant effect of the antacid component of didanosine tablets on isoniazid pharmacokinetics. The effect of didanosine on isoniazid was not studied.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Low Quality of Evidence)
Liverpool Notes:
Coadministration of rifampicin-based TB treatment (rifampicin 450 mg in patients <50 kg or 600 mg in patients >50 kg, once daily; with isoniazid, pyrazinamide and ethambutol) and efavirenz/tenofovir-DF/emtricitabine (600/245/200 mg, once daily) was studied in 21 TB-HIV coinfected patients in a crossover study. Coadministration increased efavirenz AUC, Cmax and Cmin by 8%, 2% and 11%, respectively; tenofovir AUC and Cmin increased by 13% and 9% respectively, while Cmax decreased by 2%; emtricitabine AUC and Cmin increased by 5% and 26% respectively, while Cmax decreased by 3%. Bioequivalence for the TB drugs was suggested for Cmax when administered with and without efavirenz/tenofovir/emtricitabine (coadministration decreased rifampicin by 14%, decreased isoniazid by 5%, increased pyrazinamide by 14% and had no effect on ethambutol). The combination was tolerated well by Tanzanian TB–HIV-coinfected patients. The authors conclude that coadministration of the standard first-line TB treatment regimen with efavirenz, tenofovir and emtricitabine does not alter pharmacokinetic parameters. Efavirenz, tenofovir and emtricitabine combined with first-line tuberculosis treatment in tuberculosis-HIV-coinfected Tanzanian patients: a pharmacokinetic and safety study. Semvua H, Mtabho C, Fillekes Q, et al. Antivir Ther, 2013, 18(1): 105-113. Plasma pharmacokinetics of isoniazid were determined in 15 HIV/TB coinfected patients during a study investigating dose increase of rifabutin following commencement of efavirenz. When isoniazid (15 mg/kg twice weekly) was administered with rifabutin (300 mg twice weekly), geometric mean values for isoniazid AUC and Cmax were 29.9 µg/ml.h and 6.8 µg/ml, respectively. After the commencement of efavirenz (600 mg once daily) and an increase in rifabutin to 600 mg twice daily, there was no significant change in isoniazid exposure (AUC 28.6 µg/ml.h, Cmax 7.0 µg/ml). Evaluation of the drug interaction between rifabutin and efavirenz in patients with HIV infection and tuberculosis. Weiner M, Benator D, Peloquin CA, et al. Clin Infect Dis, 2005, 41(9): 1343-9., Summary:Coadministration of efavirenz and isoniazid alone has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine. Coadministration of TB treatment containing isoniazid (with rifampicin, ethambutol and pyrazinamide) and efavirenz (with emtricitabine and tenofovir-DF) increased efavirenz AUC, Cmax and Cmin by 8%, 2% and 11%, respectively; isoniazid Cmax decreased by 5%. Coadministration of efavirenz (600 mg once daily) to 15 HIV/TB coinfected subjects receiving isoniazid (15 mg/kg twice weekly, plus rifabutin 600 mg twice weekly) had no significant effect on isoniazid AUC or Cmax (relative to values obtained when the same dose of isoniazid was administered with rifabutin 300 mg twice weekly without efavirenz).
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine. Doravirine does not interfere with isoniazid’s metabolic pathway.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Moderate Quality of Evidence)
Liverpool Notes:
Coadministration of isoniazid (5 mg/kg, up to 300 mg once daily, with pyridoxine) and lopinavir/ritonavir (400/100 mg twice daily) was studied in 16 HIV positive subjects in a cross-over trial. There was no significant effect of isoniazid on the pharmacokinetics of lopinavir (AUC and Cmax increased ~15% and ~13%) or ritonavir (AUC and Cmax unchanged). The results of this study indicate that a clinically significant drug-drug interaction is unlikely. The pharmacokinetics of lopinavir/ritonavir when given with isoniazid in South African HIV-infected individuals. Decloedt E, van der Walt J, McIlleron H et al. Int J Tuberc Lung Dis, 2015, 19(10): 1194-6., Summary:Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine. No significant effect on isoniazid is expected. Coadministration of isoniazid (5 mg/kg, up to 300 mg, once daily) and lopinavir/ritonavir (400/100 mg, twice daily, n=16) had no significant effect on the pharmacokinetics of lopinavir (AUC and Cmax increased ~15% and ~13%) or ritonavir (AUC and Cmax unchanged).
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Low Quality of Evidence)
Liverpool Notes:
Indinavir and isoniazid can be co-administered without dose adjustment. Coadministration of indinavir (800 mg three times daily) and isoniazid (300 mg once daily) had no effect on the AUC or Cmin of indinavir or isoniazid. Crixivan Summary of Product Characteristics, Merck Sharp & Dohme Ltd, October 2018. Coadministration of isoniazid (300 mg once daily for 8 days) and indinavir (800 mg three times daily for 7 days) to 11 subjects resulted in decreases in indinavir Cmax. AUC and Cmin of 5%, 1% and 11% respectively. Isoniazid Cmax and AUC increased by 34% and 12% respectively, and there was no change in Cmin. Crixivan Prescribing Information, Merck & Co Inc, May 2018. Coadministration of indinavir (800 mg every 8 h) and isoniazid (300 mg once daily) was studied in HIV+ individuals. There were no clinically significant interactions and no dosage modification is required.Indinavir (MK639) drug interaction studies. The Indinavir (MK 639) Pharmacokinetic Study Group. 11th International Conference on AIDS, 1996, abstract Mo.B.174., Summary:No data with indinavir/ritonavir. Coadministration with indinavir alone increased Isoniazid Cmax (34%) and AUC (12%) with no change in Cmin. Indinavir Cmax. AUC and Cmin decreased by 5%, 1% and 11%, respectively. The effects are not considered clinically significant and no dose adjustment is required.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid. The latter is further hydrolysed to isonicotinic acid and acetylhydrazine. Atazanavir/ritonavir is unlikely to interfere with this metabolic pathway.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid. The latter is further hydrolysed to isonicotinic acid and acetylhydrazine. Atazanavir/cobicistat is unlikely to interfere with this metabolic pathway.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid. The latter is further hydrolysed to isonicotinic acid and acetylhydrazine. Atazanavir is unlikely to interfere with this metabolic pathway.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid. The latter is further hydrolysed to isonicotinic acid and acetylhydrazine. Darunavir/cobicistat is unlikely to interfere with this metabolic pathway.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine. Elvitegravir/cobicistat, emtricitabine and tenofovir alafenamide do not interfere with this metabolic pathway.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
An open-label, intrasubject drug interaction study in HIV-negative healthy volunteers comprised investigated the pharmacokinetics of dolutegravir once daily alone and with once weekly isoniazid and rifapentine. Of 4 enrolled subjects (3 males, 1 female, age 22-46 years), 3 completed the study and 1 withdrew prior to the 3rd dose of isoniazid/rifapentine. The study was stopped prematurely due to the development of multiple AEs in 2 subjects. In both subjects, flu-like syndrome with symptoms of nausea, vomiting, and fever (Grades 2 and 3) began ~8 hours after the last doses of dolutegravir, rifapentine, and isoniazid and lasted 24-48 hours. One subject required a 24-hour hospitalization for management of orthostatic hypotension (Grade 3). Transaminase elevations (Grades 2-4) occurred in both subjects. Exposure to rifapentine and its active metabolite were similar to reference PK data, but isoniazid exposure was 67-92% higher than expected in the 2 subjects who developed AEs. Limited pharmacokinetic data suggested isoniazid/rifapentine decreased dolutegravir AUC and Cmin by 46% and 74%. Given that flu-like syndrome was reported in <4% of subjects in studies of the efficacy of weekly isoniazid/rifapentine alone, these data suggest that co-administration of dolutegravir and weekly isoniazid/rifapentine should be avoided.Early termination of a PK study between dolutegravir and weekly isoniazid/rifapentine. Brooks KM, Pau AK, George JM, et al. CROI 2017, Seattle, February 2017, abstract 409a. INSPIRING (NCT02178592) is a Phase 3b, non-comparative, active control, randomised, open-label study in HIV-1 infected ART-naïve adults (CD4+ ≥50 cells/µL) with drug-sensitive TB. Participants on rifampin-based TB treatment for up to 8 weeks were randomised (3:2) to receive dolutegravir (50 mg twice daily during and for 2 weeks post-TB therapy, followed by 50 mg once daily) or efavirenz (600 mg once daily), with 2 investigator-selected NRTIs for 52 weeks. Of 113 subjects enrolled, 69 were randomised to dolutegravir and 44 to efavirenz. Interim Week 24 results show that dolutegravir 50 mg twice daily appears to be effective and well-tolerated in HIV/TB co-infected adults receiving rifampin-based TB therapy. Rates of IRIS were low. There were no new toxicity signals for dolutegravir and no discontinuations due to liver events.Safety and efficacy of dolutegravir-based ART in TB/HIV coinfected adults at week 24. Dooley K, Kaplan R, Mwelase N, et al. CROI 2018, Boston, March 2018, abstract 33., Summary:Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine. Dolutegravir is unlikely to interfere with this metabolic pathway. However, a study of coadministration of dolutegravir and isoniazid with rifapentine was ended early due to intolerance. In healthy volunteers receiving weekly isoniazid and rifapentine, the addition of dolutegravir resulted in flu-like symptoms and LFT elevations in 2 out of 4 patients (with higher than expected isoniazid concentrations), leading to study termination. Limited pharmacokinetic data suggested lower dolutegravir exposure. Intolerance is likely to be related to rifapentine (+/- healthy volunteer status) rather than isoniazid, since in the INSPIRING study, the addition of dolutegravir to daily isoniazid and rifampicin was well tolerated in 69 HIV-TB coinfected adults at 24 week analysis.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine. Bictegravir, emtricitabine and tenofovir alafenamide do not interfere with isoniazid’s metabolic pathway.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine. Cabotegravir is unlikely to interfere with this metabolic pathway.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. No drug interaction studies have been conducted with ibalizumab: based on ibalizumab’s mechanism of action and target-mediated drug disposition, drug-drug interactions are not expected. Isoniazid undergoes hepatic metabolism whereas ibalizumab, a monoclonal antibody binding to the CD4 receptor, is likely to be eliminated via intracellular catabolism similarly to other monoclonal antibodies.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine. Fostemsavir does not interfere with isoniazid’s metabolic pathway.
Penalty:
0
Liverpool Interaction Status:
Green/Low: No Interaction Expected (Very Low Quality of Evidence)
Liverpool Notes:
Coadministration has not been studied but based on metabolism and clearance, a clinically significant interaction is unlikely. Isoniazid is acetylated in the liver to form acetylisoniazid which is then hydrolysed to isonicotinic acid and acetylhydrazine. Lenacapavir is mainly cleared as unchanged drug and does not interfere with isoniazid’s metabolic pathway.