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Increase of Reyataz dosing

Oct 12, 2008

Dear Doctor

Wrote to you a number of times over the past few months, but here's sum up of my situation. I'm on Truvada, Reyataz and Norvir, been undetectable for about nine months with CD4 rising from 11% to 28% in this timeframe. Since May my VL has been detectable again, but no higher than 180. CD4 have pretty much stayed stable, last time at 680. I'm 100% compliant in taking the medication as prescribed. A Reyataz screening indicated that the quantity in my blood, though in an acceptable range, was a little on the low side. As a result, my doctor has increased the daily dosing from 300mg to 400mg. Any thoughts? Do you think this can be a viable solution or would it bring in additional issues?

Many thanks. G.

Response from Dr. Holodniy

It's possible that it may help. The tenofovir in the truvada could be decreasing the atazanavir levels. However, the ritonavir should be accomplishing the increase for the reyataz with your current dose. In many studies raising the PI dose didn't change the viral load much. Another possibility is to change to another ritonavir boosted PI like Kaletra or Prezista, or changing classes of drugs.

How does this read?
Does high ALT & AFP mean Liver Cancer?

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