ESRD WI extensive PI, NNRTI, and NRTI resistance

Mutations: L10V, M46I, A71T, L89V, L90M, M184V, K65R, Y181C
Comorbidities: None
Comedications: None
Treatment history: None
Current regimen: ETR (Etravirine/Intelence) , RAL (Raltegravir/Isentress) , TDF/FTC (Truvada)
Adherence: Penalize regimens with IV/IM dosing
CD4: ≤ 200
Viral load: Low (200 - 100,000)
HLA-B5701: Negative
Tropism: Unknown
View results
Submitted by maunank on Fri, 05/29/2020 - 10:40

55 year old recent COVID and on vent.  2010: Genotype  L10V, M46I, A71T, L89V, L90M, M184V.  (resistance to protease inhibitors (except darunavir) and emtricitabine/3TC (M184V)).2014  start on darunavir/ritonavir, dolutegravir2015:  VL undetectable.  However, daily hives.  Switched to raltegravir, etravirine, emtricitabine, TDF 2015:  undetectable viral load2018:  2280 copies/mL  , CD4 1382018:  469 copies/mL, CD4 2452018:  CD4 257 with VL undetectable2019:  new high viral load of 100KGenotype not done2020:  severe illness with COVID,:  K65R  Y181C. INSTI genotype without resistance mutations. CD4 count 96 (but total lymphocyte count is 250-700 during that time)

Regimen Weighted Score Active Drugs Total Pills Frequency (x/day)
DTG+3TC/AZT 5.95 2 4 2
DTG+AZT+FTC 6.15 2 5 2
DTG+IBA 6.4 2 2 2
DTG+IBA+DOR 6.75 2.67 3 2
DTG+AZT+TDF 6.75 2.33 5 2
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