POZ Community Forums
Meds, Mind, Body & Benefits => Questions About Treatment & Side Effects => Topic started by: buginme2 on July 15, 2011, 02:57:55 am
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http://www.smartplanet.com/blog/rethinking-healthcare/the-math-behind-how-hiv-drugs-work/5724
If you look at the dose response curve for nnrti's and pi's its significantly more vertical than nrti's. Adjustments in dosing either direction could have a significant effect.
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the real research work is reported here:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3088572/?tool=pubmed
and it is accessible for free.
It does not make any comment whatsover about dosing adjustment.
The research work is revisting the way pharmacologist look at the optimal dose IN VITRO.
In vivo dosage implies may other factors.
the original paper states:
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As we and others have pointed out (33, 56–58), IIP is only one of several factors that determine the magnitude and durability of viral suppression by antiretroviral drugs. Other factors include drug half-life, distribution, toxicity and tolerability, drug interactions, and genetic barriers to resistance. A study by Henrich et al. (57) shows that IIP and inhibitory quotient have only modest correlations with clinical trial outcomes as measured using intent-to-treat analysis after 48 wk.
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The idea is basically to try to narrow down the scope of the numerous clinical trials in order to optimize the on going (costly) validation of current and future drugs.
At this point, the authors for the original work does not claim any impact on the perception that patients should have about current dosing.
the work is promising as more research is being done towards treatment simplification (maintenance mono therapies)
just some thoughts
Eric
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''Why it may not be a good idea to reduce your dose of HIV meds''
I think 'may' is the operative word here, isn't it?
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This paper tells you nothing about whether it is or isn't a good or bad idea to reduce or not reduce your meds dosing. It tells you that different ways of calculating how drugs inhibit wild-type and mutated HIV virus gives different results, which may inform your understanding of resistance testing in a research setting.
- matt