Question:
Being that we need to think of HIV as a "chronic disease" now, isn't it dangerous to initiate combination therapy including a protease inhibitor in the early stages of infection due to the damage these drugs could cause to visceral organs? And if in fact the virus mutates around all PI's if it mutates around one, isn't early treatment risking the later benefits of this family of
drugs?
Dr. Torres' Response:
This is a very good question, in general the thought is that if you keep
viral replication suppressed totally from the very beginning you should avoid
the emergence of drug resistance, yet this implies a very potent triple
combination regimen usually and extremely good long term compliance. The
relative benefit versus risk of early treatment with PIs have not been
totally determined.
Ramon Torres, MD
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