|Reducing Meds a Bad Idea?
Oct 5, 2007
At the advice of my doc, I began meds (Atripla) after 4 years since initial diagnosis due to the slow progression of the virus in my body. Within one month of meds, I was surprised to discover I was undetectable so fast. I was wondering if there was any research or case studies to support reducing dosage of meds for people who respond well to treatment as an option??
| Response from Dr. Henry
So called induction/maintenance studies have had a checkered past. When effective three drug regimens have been reduced to a single non-boosted protease inhibitor or dual nucleoside regimen the failure rate has been unacceptable compared to continuuing the initial effective three drug regimen. I would infer the same problem for non-nuke reverse transcriptase inhibitors currently available (nevirapine or efavirenz) due to a low barrier for resistance (not to be used with a single nuke or as mono-therapy for maintenance). Use of a boosted protease inhibitor as a "mono- maintenance treatment has been somewhat more successful and is still under study. I often start off with a 4 drug induction regimen with a high barrier to resistance and then simplify to an individualized maintenance regimen (often a regimen like Atripla) once fully suppressed (below the level of detection for the HIV RNA assay). KH
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