Apr 14, 2001
What are your thoughts on mono theraphy?
Response from Dr. Young
In general terms, I'm not a fan of monotherapy with our current HIV drugs. This statement is based on many early clinical trials that showed the inferiority of monotherapy compared with dual- or triple therapies. A big concern (and clinical managment nightmare) for me is the fallout of monotherapy- largely drug resistance to the drug used, moreover the likelihood that resistance to the first agent used will cause cross resistance to other (or all) other drugs of the same class. This statment is especially true for non-nukes and protease inhibitors.
There is one special circumstance where we have used monotherapy in our clinic- this is the situation of the patient with multi-drug resistant virus- in persons who have been on all available drugs with poor tolerance of combination (or mega-HAART) regimens. In select cases, we have used single drug therapies in the hopes of modest reductions in viral loads with minimal side effects. This strategy is done in the hopes of delaying disease progression until better tolerated and more potent regimens might be available (at which time monotherapy would be abandoned for combination therapy). BY
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