Dr. Holodniy,

I'm wondering if you may have some thoughts on a treatment modification that I've recently discussed with my physician. I've been positive for more than 20 years. I've been taking SQV/RTV for nearly 12 years, currently as SQV/RTV 1000/100 mg BID. Under my doctor's direction, I've been using this combo with no other HIV med for about 5 years now. It's worked great--VL undetectable all that time, CD4 count in the 700-800 range.

Naturally, I'm experiencing some mild lipid abnormalities. So, my question is--do you or anyone you know have experience in using SQV/RTV 2000/100 mg once daily? This would just be more convenient, of course, but I'm also hoping it could have at least some positive effect on my somewhat elevated LDL and TG levels.

I'd be grateful for any insights you could provide.

Thanks,

There have been small, primarily drug level/concentration studies in HIV infected people addressing this question. Yes, 2000/100 once daily can be given and provides somewhat higher levels of saquinavir with half the dose of ritonavir. In one small study lipids were not affected by reducing the ritonavir in half and doubling the saquinavir dose. So, it is likely to be effective and maintain your undetectable viral load, but might not have an effect on lipid levels.