Hi, I have been poz for 17 years. I am currently taking reyataz(200) and norvir 100 as a boster. As well I am on Sustivia and Ziagen. My cd4 is around 900-1000 my % is 41. I am undetectable. I recently read and article saying I could give up the norvir. Can I?

Am I on a weird combo? I have too many side effects and would perfer an easier treatment...I have recently developed a lipo belly...it is very discusting. I want to be on the most effective treatment with the least side effects....Can you help me out?

JB on the Rock

Dear JB

Your combination is not a usual one, but there is no cookbook as long as it works. It is possible that you got to this combo through others that had to be changed for one reason or another.

The short answer is with the combo you are on NO, you should not stop the norvir. It is necessary to keep the combo in balance. There is an interaction between Sustiva and Reyataz...when combined the Reyataz levels will be dropped significantly in the blood, so low that it may compromise the ability of reyataz to suppress HIV. The Norvir is needed to block the break down or Reyataz in the liver so that it's blood level remains high enough to kill HIV even if Sustiva is around. The usual dose in this setting would be 400 mg of Reyataz (not 200 mg as you mention) with 100 mg of norvir and 600 mg of Sustiva.

The study I think you are thinking about is one called ARIES in which ziagen with epivir was given with Reyataz and Norvir and after getting the virus suppressed the norvir was stopped (and the reyataz dose was increased from 300 mg to 400 mg) and people stayed undetectable. The big difference is that they were not on Sustiva. You should speak to your health care provider. With new medications out now that may not have been around when your cocktail was mixed it may possible to reconfigure it safely.

Stay on the Rock.

Joe