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Switching to Atazanavir
Jun 4, 2004

Thank you so much for your prompt response to my previous question. You all are doing an invaluable service on this forum! Thank you again.

I guess my next 2 (and final) questions would be:

1. Would you recommend Atazanavir alone or the boosted regimem with Ritonavir?

2. Sice my viral load is still detectable, would you switch the AZT/3TC as well? In that case, to what?

My original question and your response:

On Nelfinavir/3TC/AZT for 5 years. Firs and only combo. Viral load was never undetectable. Currently at 1,200 and CD4 500. Lipo dystrophy has been bothering me. ---------- It sounds as though your viral load has just recently become detectable at 1,200. Unless you have missed doses, or changed your schedule or regimen somehow, it is probably beginning to fail. Usually it is not a good idea to change out only one portion of a failing regimen. I am not sure that Reyataz will actually reverse any lipodystrophy.

Response from Dr. Lee

Best bet is to try for a genotype or phenotype and review options with your doc using that added info. I would suspect a 184 reverse transcriptase mutant and perhaps a D30 protease mutant. If those are the only mutations, it is probably worthwhile to start on unboosted Reyataz and closely watch how well it works. You could also consider Zerit or Ziagen.

Be well.



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