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Are 2 PI's Enough?
Jun 30, 2005

I am on salvage treatment. I am resistant to NNRTIs and NRTIs. My viral load is 0 and CD4s 300. I did T20 for 18 months and had to discontinue due to ISRs. I take Saquinivir500 and Lexiva with Norvir. I also take 3TC (even though I am resistant to it). My Dr. wants me to take Viread (am mildly resistant) but it makes me feel even more ill. My question: is dual PI therapy enough? How safe is it? Should I deal with feeling even worse (I am on disablity due to the side effects) in order to have this regimin work longer? Thanks in advance - you guys are great and I really appreciate this site.

Response from Dr. Pierone

As a general rule if a regimen produces complete suppression of virus, then it is potent enough and may be left alone. Adding another agent when the viral load is undetectable is not advisable. It simply adds cost, toxicity, and this strategy has not been proven to change the long-term outcome.

In terms of safety, dual PI therapy appears to be safe. The side effect profile depends on which PIs are chosen. The combination of Lexiva, Invirase, and Norvir is not a stroll in the park, but most people are fine with them. Good luck to you.



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