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Are there alternatives to protease inhibitors?
May 15, 2013

After 25 years of low or undetectable viral loads, it went up to about 10,000. My doctor gave me a resistance test, which I have not yet seen, and changed my meds to Norvir, Isentress, Prezista, and Edurant. I already have neuropathy in the toes and a "crixivan belly", which are, I'm told, typical side-effects of protease inhibitors. I'm not sure what my virus is resistant to, but I'm very resistant to continuing with protease inhibitors, especially since I've begun serious body-building. Are there alternatives?

Response from Mr. Vergel

Your HIV regimen contains an integrase inhibitor, a boosted protease inhibitor, and a non-nucleoside. This type of combo is prescribed with people with multidrug resistance that usually have very few options beyond these drugs. You should ask your doctor to go over your genotype or phenotype test results with you and ask him/her that question. You may be taking the best combo that gives you the best chance at sustained undetectable viral load in the long term.

By the way, none of the medications you listed are associated with worsening of existing neuropathy. Also, many HIV positive people on boosted protease inhibitors bodybuild without problems. If your question is about whether switching away from a boosted protease inhibitor would decrease abdominal fat, there are conflicting studies on this issue. If your lipids and glucose are normal, then you should not be worried about worsening of your belly fat issues with boosted Prezista, which has been proven to be one of the least problematic protease inhibitors in the market along with boosted Reyataz when it comes to metabolic issues.

In health,

Nelson



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