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Future of HIV meds
Mar 20, 2007

I am another Dr. Bob, in schoolpsych from Columbia U. Last summer, I neglected meds after being on them since 1990, then got sick, then sent to Highbridge Woodycrest in Bronx, where a simplified regimen of Kaletra and Trizivir was prescribed. My question is whether HIV meds are likely to become even simpler with progress. With Fish Oil and a multivitamin and 81 mg aspirin, and Metropolol Titrate for heart, I also plan to be very very old (now I'm 60). (P.S. Where was your med school? If it was Columbia U Presbyterian, I can see its flag through my Apt. window)

Response from Dr. Frascino

Hi,

Well, with meds like Trizivir, which combine three medications into a single pill, or Kaletra, which has two (lopinavir plus a ritonavir boost), things have already gotten much simpler than "the bad old days." Remember when AZT was the only HIV medication available and it had to be taken every four hours around the clock? Or when Crixivan was the drug du jour and required dosing every eight hours on an empty stomach (one hour before or two hours after food) with 1.5 liters of water? The HIV newbies of today often can take something like Atripla, which is a single pill (combining three different medications, efavirenz, emtricitabine and tenofovir) taken once per day. You really can't get much "simpler" than that in terms of pill burden or dosing convenience. Consequently, I don't think we'll be seeing much progress in further "simplifying" what we currently have. The real challenge is going to be developing potent anti-HIV drugs that are better tolerated. Short- and long-term drug side effects and toxicities are the current most pressing problems that require immediate attention. Stay tuned to The Body. We'll keep you updated on new and evolving therapies.

As for medical school, I attended the University of Cincinnati School of Medicine. I then headed west for postdoctoral training, initially a pediatrics residency at Children's Hospital of Northern California and subsequently a postdoctoral fellowship in adult and child clinical immunology, allergy, asthma and rheumatology at the University of California San Francisco. I'm sure the Columbia U Presbyterian flag is quite lovely but from my office window I could see the San Francisco Golden Gate Bridge!

Stay well. Don't neglect your meds!

Dr. Bob



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