Reyataz vs Kaletra

Jan 22, 2006

I am currently taking boosted Reyataz and have high billirubin causing yellow eyes. I am considering switching to Kaletra. I am recently diagnosed and in addition taking Truvada. My question is boosted Reyataz with Truvada more favorable towards minimizing lipodystrophy vs taking Kaletra with Truvada?

Response from Dr. Young

Thanks for your post.

You're having one of the more common side effects of atazanavir (Reyataz)-- yellowing of the eyes (scleral icterus) or of the skin (jaundice) affects a small percentage of patients. The rate appears to be higher among persons who take atazanavir with ritonavir (Norvir) boosting.

Switching from one boosted PI to another is a very reasonable way to proceed-- there are no head-to-head data on the two PIs in first-line treatment, so comparisons are speculative. It's probable, though not proven, that lopinavir/ritonavir (Kaletra) will result in higher cholesterol and triglycerides (lipids), there's less to go on to predict rates of lipodystrophy. As you'll read from my other posts, I'll tend to use boosted fosamprenavir (Lexiva) in this situation, since the lipid profile seems better than Kaletra. In either event, neither fosamprenavir nor Kaletra causes icterus or jaundice, so your symptoms should improve.

Best of luck, BY