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decrease in dosage of crixivan+norvir / is it safe?

Feb 13, 2001

hello doctor - after 28days of contracting the hiv i began an haart therapy . 1 combivir+ 800mg crix.+100mg norvir (twice a day). from vl well above 750.000 (pcr) t4 = 414 and t4/t8 of 0.69 , i went 1 month later to vl =1600 t4 = 713 and t4/t8 of 1.35 . the treatment seemed to work very well thanks to the early start of it. 6 weeks after the start my doctor proposed me to decrease the dosage of crix to 400mg instead of 800mg - however i stand the treatment quite well - my questions are 1) is it safe ? 2) is there any risk of resistance ? 3) is this dosage enough ? 4) has it been tested before? 5) am i on a trial? i don't want to spoil my "chance" to have begun the treatment so early and for me 800mg of crix. is well tolerated by my body till now . thank you very much for your point of view and for this terrific forum for people who caught this nasty virus.

Response from Dr. Pavia

Thanks for your kind words. I am not aware of any really good pharmacology data that supports 400 of crix with 100 of norvir. A regimen that also gives good levels is crixivan 400 with norvir 400, but it is generally a little harder to take that much norvir. The whole weakness of the old crixivan dosing schedule was that borderline low levels would occur at the end of the 8 hour dosing interval. You should never be part of a research study if you have not given your explicit permission and signed a detailed informed consent.

Sooo, in light of the fact you are doing so well I would be very reluctant to lower the dose of crixivan, even though it might work. Having started so early you should keep a close eye on the research on treating acute seroconverters. If the work pans out, it may be possible someday to get you off of the drugs, at least for a while. However, the research is in very early stages, and it is too early to play around outside of a research setting. You are in good shape right now, and on a regimen that makes good sense.


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