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KALETRA MONOTHERAPY?
Jun 13, 2008

I've been on Kaletra Monotherapy of 22 months and remain undetectable and my CD4 count went from 350 to 550. I am managing my triglycerides and cholesterol with diet, exercise and fish oil.

What's your opinion with the monotherapy?

Should I stick with it as long as it's working for me?

Thanks for any opinion you may have.

Response from Dr. Frascino

Hello,

In selected individuals, maintenance monotherapy with lopinavir/ritonavir (Kaletra) appears to be associated with a low risk of virologic rebound and/or the development of protease inhibitor resistance. However, whether or not this strategy should be used in a non-clinical trial setting remains debatable at best, particularly in light of the fact the new nucleoside reverse transcriptase inhibitors are now safer and have fewer side effects (lipoatrophy and other complications mediated by mitochondrial toxicity). In general I would reserve Kaletra monotherapy for individuals in a clinical trial where they are closely monitored or for folks who are intolerant of the other therapies. That said, it's always hard to argue with success. And you've obviously been successful so far. Certainly if someone is using monotherapy, adherence becomes even a more critical issue. Personally I would feel more confident using combination therapy.

Good luck.

Dr. Bob


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