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Apr 7, 2006

Dear Dr. I was wondering if boosting you PI with Norvir only lessens the number of pills needed? Is there any other benefit from the Norvir itself? Thank you

Response from Dr. Young

Thanks for your post.

The use of ritonavir (Novir) to boost other protease inhibitors has gained popularity for first-line treatment, and is essentially standard of care for second- or subsequent lines of HAART.

Part of the reason for this is reduction in the pill count for some PIs; indinavir (Crixivan), saquinavir (Inverase). Other PIs have little change in total pill count with ritonavir-- fosamprenavir's (Lexiva, Telzir) is 4 unboosted, or 2 with 2 ritonavir; atazanavir (Reyataz) daily pill count goes from 2 to 3.

Like any treatment strategy there are strengths and weaknesses-- to me the most important strength is the thought that boosting minimizes the drug resistance consequences of first line treatments. To date, data from patients experiencing first-line boosted PI failure only have shown the M184V mutation-- no measurable resistance to PIs or other nukes have been seen (for the vast majority). This may result in better preservation of future treatment options.

Most importantly, boosting of PIs allows us to consider successful treatment for patients with drug resistance, even multidrug resistance-- using a ritonavir-boosted PI as the anchor to other medications.

Offseting this is the increased risk of having elevations in lipids (cholesterol and triglycerides)-- but, the newer PIs atazanavir and fosamprenavir have shown encouraging results in studies of naive patients.

I hope this helps clarify your question, BY

truvada and marijuana
Drug holiday for me ?

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