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Author Topic: Why a combo?  (Read 1130 times)

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Offline egello

  • Member
  • Posts: 899
  • cb
Why a combo?
« on: September 09, 2008, 03:50:12 PM »
I don't get this, and my doctor couldn't give me a clear explanation neither.

If my viral load is and has been undetectable for some time, why can't i just just take one Reyataz and not have to deal with taking Norvir. Why do I must mix it with Non Nuke as Truvada? I understand that to get it down to undetectable, it was necessary, but why must I still continue with the combo now?

"In a comparison of boosted and unboosted atazanavir, overall efficacy results were comparable [135]. However, the study was not powered to demonstrate non-inferiority of unboosted atazanavir, and there were numerically fewer virologic failures and less emergence of PI resistance in patients in the boosted atazanavir arm."

this kind if statement makes me think that it is that much of a big deal whether the Reyataz gets boosted or not boosted and what if the Reyataz level get bit low, isn't there enough Truvada in the system to keep any viral reproduction?
« Last Edit: September 09, 2008, 03:54:12 PM by egello »
Reyataz / Norvir / Truvada/ Androgel 5 g / 2 days
1/29/07 14 T, 300 k V, 1.8 %
2/22/07 197 T, 247 V, 6.8 %
3/27/07 164 T, <50 V, 5.4 %
5/28/07 177 T, <50 V, 8.2 %
7/28/07 214 T, <50 V, 9.6 %
10/3/07 380 T, <50 V, 10 % no more Mepron, Famvir

Offline Assurbanipal

  • Member
  • Posts: 2,173
  • Taking a forums break, still see PM's
Re: Why a combo?
« Reply #1 on: September 09, 2008, 05:14:27 PM »
I think the idea is that being undetectable means that you have far fewer virus breeding within you.  But it doesn't change the fact that when theones that are left breed some mutate into strains that are resistant to one drug, some into strains that are resistant to a different drug and so you still need multiple drugs to kill the regular virus plus the mutants.

(Sorry about the ewwww factor)
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline aztecan

  • Member
  • Posts: 5,384
  • 29 years positive, 56 years a pain in the butt
Re: Why a combo?
« Reply #2 on: September 11, 2008, 12:43:49 AM »
Egello,

What you are talking about is monotherapy, which doesn't maintain undetectable viral loads for very long.

The reason is when one class of drug, like the PI Reyataz, is attacking the virus at one stage, the Truvada, a nuke, is attacking it at another stage of the virus' replication process.

It also was discovered that, should the virus become resistant to one type of drug, it often remains sensitive to other types of drugs, preventing the replication of mutant strains of HIV formed in your body by the millions.

As for the Norvir, well, that is just part of the deal. You are not treatment naive, which is when unboosted Reyataz is used.  By the way, the amount of Reyataz taken is also different,  greater, than the amount taken with a Norvir boost.

I am not crazy about Norvir. Even at 100 mg doses, I still get some stomach upset from it. But, its no worse than the nausea that taking Crixivan and AZT on an empty stomach caused for 11 years.

So, the answer to your question is, "Cause it probably won't work for very long."

HUGS,

Mark
« Last Edit: September 11, 2008, 12:47:09 AM by aztecan »
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline egello

  • Member
  • Posts: 899
  • cb
Re: Why a combo?
« Reply #3 on: September 11, 2008, 11:56:33 AM »
Thanks for the clarification, so I guess undetec doesn't mean that you are mostly free of the virus in any one given bodily fluid sample....
Reyataz / Norvir / Truvada/ Androgel 5 g / 2 days
1/29/07 14 T, 300 k V, 1.8 %
2/22/07 197 T, 247 V, 6.8 %
3/27/07 164 T, <50 V, 5.4 %
5/28/07 177 T, <50 V, 8.2 %
7/28/07 214 T, <50 V, 9.6 %
10/3/07 380 T, <50 V, 10 % no more Mepron, Famvir

 


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