Subspecialists request simplified ART for a 56-year-old woman with a long ART history, who is taking a DOAC, has evolving renal function, and some drug resistance. Which factors to prioritize? Eileen and Chris have some, but not a complete medical history. Listen as they work through the information they do have, consider 7 questions key in making an ART switch, and evaluate the available options.

References and Resources Cited:

• Paton NI, Musaazi J, Kityo C, et al. Efficacy and safety of dolutegravir or darunavir in combination with lamivudine plus either zidovudine or tenofovir for second-line treatment of HIV infection (NADIA): week 96 results from a prospective, multicentre, open-label, factorial, randomised, non-inferiority trial. Lancet HIV. 2022 Jun;9(6):e381-e393. Epub 2022 Apr 20. PMID: 35460601.
• University of Liverpool HIV Drug Interactions: Interaction Checker
• FDA: Apixaban (Eliquis) Highlights of Prescribing Information
• FDA: Dabigatran etexilate (Pradaxa) Highlights of Prescribing Information  
• FDA: Edoxaban (Savaysa) Highlights of Prescribing Information

Related NYSDOH AIDS Institute Clinical Guidelines: 

• Second-Line ART After Treatment Failure or for Regimen Simplification
• Resource: ART Drug-Drug Interactions; specifically, see Drug-Drug Interactions by Common Medication Class Table 22: Anticoagulants
• Primary Care for Adults With HIV