Kaletra or Reyataz/Norvir

[Ihavehope]

I have read many people's threads in regards to both of these.

It appears that the recommended regimen for me is Truvada plus a PI which could be Kaletra or Reyataz plus booster. What are your expriences with both? Doc seems to favor Kaletra.

[thunter34]

Kaletra has a good reputation of being a very stable compound that (when used properly....read: adherently) has a pretty good lifespan as part of a first line regimen.  That is, it has a good track record against developing resistance.  It can be a real bitch (no other word for it) for some people at first.  It knocked me down hard for weeks and weeks while I was getting adjusted to it.  Also has a not so good rep for wreaking havoc with blood lipids.  My own cholesterol has been astonishingly high on it at times.  Like walking stick of butter high.  The old formulation just plain sucked for me in the area of user-friendliness (needing refridgeration and to be taken with high fat foods).  I swelled up 30 lbs in 3 months on it.  Took some work to get that back off.  The new formulation is SO much better.  No fridge needed and no food has to be eaten with it.  Also the dose has been reduced to either 4 pills once a day or 2 pills twice a day (the route I go).  This is down from 3 pills twice a day.  It is a big tablet now instead of a big nasty gross ass gel cap.  (Can you tell I still harbor animosity for the old formulation?  Picking up on that one?)

[Johnny Guaylupo]

I take Truvada and Reyataz/Norvir and it's been great my numbers went flying up ....

[newt]

Both of these are effect combos. Reyataz/Norvir uses less Norvir (half) compared to Kaletra (which has Norvir already in it). Norvir is prob responsible for a lot of the bad effect PIs can have on lipids (blood fats). Reyataz is a genuine 1 x day pill.  Kaletra can be taken 1 x day if you have never taken PIs before, but was designed for 2 x day use and is still best used that way. If you have a busy schedule, and timing may be difficlt, Reyataz is prob better here because it has a longer safe dosing window. Kaletra/Truvada is 5 pills with the new tab formulation or 7 pills with the old gel caps.  Reyataz/Norvir/Truvada is 4 pills. Reyataz does cause some yellowing of eyes at the beginning, and sometimes skin, but this tends to pass. Kaletra seems to cause fatigue more than Reyataz.  How people react to different combos is in the end individual.  Most people would say Reyataz is easier to take than Kaletra, but this is not so for everyone.  Regarding, fat gain. no-one really knows which drugs cause this.  PIs historically have a bad reputation, but I have seen the same with people on NNRTIs. HIV hijacks your fat metabolism, so hammering it down with combo makes this available to your body (to, er, lay down for winter).  I am not sure what your doc says about more drug interactions with Reyataz is strictly true or relevant. Choice is yours, good your doc gives you a choice.

- matt

[trellium]

Hi Ihavehope,

I've been on Truvada & Kaletra (once daily dosing) for 6 months now, and the results have been pretty good.
Like what thunter said, the old capsule formulation was a bitch (took it for 8 weeks) but the new tablet formulation is SO SO much better. 
The no food, no fridge restriction is a godsend, so is once-daily dosing
I don't have any side-effects from the meds now, hell even the dreaded D and loose stools stopped all of a sudden after week 24 with no dietary changes.

My numbers were quite similar to yours when I started:
baseline CD4=178 (34%) VL=23,400 and got undetectable by week 8
My last lab (week 16) showed CD4=469 (36%) VL <50 
Cholesterol, triglycerides, HDL, LDL, kidney & liver function levels are all (still - and keeping my fingers crossed) within the normal ranges.

Both Kaletra and Reyataz/r are both very effective, but Reyataz has an edge for its lipids-friendly profile.
Kaletra has a higher genetic barrier and is harder to develop resistance to.
Kaletra has Norvir in it, whereas its an extra cap (refridgeration required) with Reyataz.

You also have the option to change meds if one combo doesn't work out right for ya.

Decisions, decisions...

[Robert]

What Johnny said.

 ("I take Truvada and Reyataz/Norvir and it's been great my numbers went flying up ....")

I agree.