|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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