Three Weeks Later...
TDM reveals low amprenavir & lopinavir levels
Viral load started to ? fall, but lipid levels ??
Management options:
- ? amprenavir, lopinavir/r dosages
- add extra ritonavir
- both options may further exacerbate lipids, other toxicities
- replace efavirenz with delavirdine
- still including full-dose NNRTI in regimen
- since delavirdine is an enzyme inhibitor, will boost PI levels without risk of significantly increasing lipids