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Some questions
Dec 19, 2012

Hi doctor, I have some questions. I will be very happy if you can help me. 1: I would like to chande kalletra. Because I wanna a more safe drug. What drug you think I can try? 2: Im afraid to have bones problems. Nowadays we can avoid better this problems. I can be more relax? 3: I would like to know your opinium about Il-7. Thanks a lot!

Response from Dr. McGowan

Hi,

Let me try to address your questions:

1) Yes, there are alternatives that may have less side effects for you than Kaletra. Within the Protease Inhibitor family both Atazanavir (Reyataz) and darunavir (Prezista) bith given with ritonavir (Norvir) have a good heart-healthy profile. You would need to check with your medical provider to be sure your virus does not carry resistance or that you are not on any medications taht could cause an interaction with them. It may be possible to construct a regimen around drugs from outside the Protease inhibitor class (such as a NNRTI (non-nucleoside reverse transcriptase inhibitor) or an Integrase inhibitor or CCR5-antagonist. These drugs are less protective against drug resistance, so it wuld be very important for your medical provider to review any past treatment failures that you may have experienced before you got on Kaletra. 2) Bone density issues can be very common these days. Some things that you can do are to maintain a normal vitamin D level and eat a balanced diet, do regular excercise, and have your bone density checked. Tenofovir, a commonly used medication, may have an efffect on bone density, although it has not been a cause of higher rates of bone fractures. 3) Il-7 is a natural substance made by cells of the immune system called a cytokine. Cytokines are used by the body to keep the immune system in balance and functioning normally. Sometimes, after a person starts anti-HIV meds they get their HIV down to undetectable but their T cell (CD4) count stays low. IL-7 might be useful to increase the number of CD4 cells (and hopefully their function as well). So, if the studies support it, one day we may use treatments like Il-7 to help restore th eimmune system while on suppressive anti-retroviral therapy. It would not be a substitute for treatment but could compliment treatment to get the best boost to the immune system.

Best, Joe



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