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New "diet" doubt

Oct 11, 2017

Doctor Young, Ive been on Kaletra + Tenofovir/Lamivudine for 10 years. Now, my health care provider wants to replace Kaletra by another PI. I have two options: Prezista/Norvir (600/100 mg) once a day or Atazanavir/Norvir (forgot the dosage). The Tenofovir/Lamivudine continues because of HBV co-infection. What choice you think its the better one?

Response from Dr. Young

Hello and thanks for posting.

It's reasonable to consider switching from Kaletra to more modern boosted protease inhibitors: they're far better tolerated.

Of the two, I favor the darunavir (Prezista, also coformulated in Prezcobix) over atazanavir. This is reflected in current US treatment guidelines where the former is a component of recommended initial regimens, and the later is not.

You've not mentioned if there's any concerns about viral drug resistance, but this situation also favors darunavir. Know that the dosing of Prezista is different if you have virus with protease inhibitor resistance- it's once daily for drug sensitive virus, and twice-daily for certain resistant viruses.

I hope that's helpful. BY



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