33-yr-old woman with substance use disorder and HIV admitted with fever and chest pain
‒Onset 1 wk ago in the context of relapsed IDU (ie, heroin and cocaine)
‒Previously stable on opiate replacement therapy
Past medical history: HIV on DTG + FTC/TAF with excellent adherence until relapsed IDU; most recent HIV-1 RNA < 20 copies/mL 3 mos ago
‒HCV infection previously treated with SOF/VEL, SVR (cure) confirmed
‒Endocarditis secondary to IDU
‒Underwent bioprosthetic aortic valve replacement 5 yrs before current admission
Previously failed Atripla
Now admitted with recurrent bioprosthetic MSSA endocarditis, being started on oxacillin + rifampin. What do do about ARV?
| Regimen | Weighted Score | Active Drugs | Total Pills | Frequency (x/day) |
|---|---|---|---|---|
| DTG+TDF/FTC | 2.45 | 2 | 3 | 2 |
| DTG+TAF/FTC [Current regimen] | 2.95 | 2 | 3 | 2 |
| RAL+TDF/FTC | 7.4 | 2 | 5 | 2 |
| RAL+TAF/FTC | 7.9 | 2 | 5 | 2 |
| DTG+IBA | 8.5 | 2 | 2 | 2 |