Treatment -experienced with virologic failure

Mutations: M41L ,D67N , K103N ,Y181C, M184V, G190V, L210W ,T215Y ,P225H
L10I, I13V, K20R, M46L, I54V ,T74P, L76V , V82A, I84V, L90M
N155H
V38A
Comorbidities: None
Comedications: None
Treatment history: None
Current regimen: DRV/r (Darunavir-ritonavir/Prezista and Norvir) , TDF/FTC (Truvada)
Adherence: No options selected
CD4: ≤ 200
Viral load: Low (200 - 100,000)
HLA-B5701: Negative
Tropism: X4 virus
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Submitted by DR MATIN AHMAD KHAN on Sun, 11/07/2021 - 05:41

Here the patient is on DRV/r twice plus FTC/TDF and have wide spread mutations against RT, Protease Integrase and even Entry inhibitor gp41. 

What best would be to be included for this patient ?

1. IBA & DTG

2.FOS & DOR

3.FOS & ENF

4.IBA & RAL

 

 

Regimen Weighted Score Active Drugs Total Pills Frequency (x/day)
DTG+FOS+IBA+TAF/FTC 7.65 3 5 2
DTG+FOS+IBA+TDF/FTC 7.75 3 5 2
DTG+FOS+IBA 7.75 2.67 4 2
DTG+FOS+IBA+DRV/r 8.4 3 8 2
DTG+FOS+IBA+DRV/r+TAF/FTC 8.65 3.33 9 2
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