Reyataz mono-therapy

[Pippet]

My doc made mention of Reyataz (400mg) being used as mono-therapy.  I was wondering if anyone has heard of this or tried it.
It just struck up my curiosity...

Take care.

[gerry]

I believe there are a few preliminary Reyataz monotherapy studies but only with Norvir boost, and not in the unboosted form.

[trellium]

Here's an article Pilot Study of Boosted Atazanavir Monotherapy Terminated Due to Virological Rebound

http://www.hivandhepatitis.com/recent/2007/012307_b.html

"Ritonavir-boosted atazanavir as maintenance monotherapy in HIV-1 infection might not be as potent as conventional [antiretroviral therapy]," the authors concluded, adding that, "Serum bilirubin should be further studied as a biomarker of adequate atazanavir exposure."

[newt]

As with the Kaletra monotherapy studies, the nukes seem to be doing something and, while an interesting option to look at further, more studies are needed.

A few more

Atazanavir/r monotherapy and CNS penetration
1 out of 30 people here didn't stay undetectable.  Maybe importantly, central nervous system penetration of Reyataz (atazanavir) was not so good.

Simplification to atazanavir/ritonavir monotherapy
5 of 36 people here (counting drop-out as failure) had viral rebound

Resistance implications of monotherapy with lopinavir/r (Kaletra)
This is a report from the MONARK study, which randomised 136 people starting treatment for the first time with a viral load under 100,000 copies to either Kaletra monotherapy (83 people) or Kaletra+AZT+3TC (53), with follow-up for 96 weeks. A significantly greater percentage of patients receiving monotherapy had viral rebound or poor suppression: 21/83 vs 3/53 (25% vs 6%).

In all PI monotherapy studies, many people do well. But overall not as well as people on full combo. Reyataz may  not be potent enough to be a safe bet, although studies so far have all been small, so no firm conclusions can be drawn.  Kaletra, maybe, for people who have never used PIs, workable if they have perfect adherence and no baseline resistance. We need a big study really.  Already having an undetectable viral load for some months before going on a single boosted PI v starting on one is also probably also important to the outcome. Long term durability needs looking at too.

Pippet, your doc, while looking forward and being modern is one penny short of a silver dollar, if it is to be Reyataz monotherapy it needs to be (like gerry said) with a Norvir booster.

- matt

[Pippet]

Thanks for the links.  I was not considering this treatment.  I was just curious about what results they were having with it.

Pippet, your doc, while looking forward and being modern is one penny short of a silver dollar, if it is to be Reyataz monotherapy it needs to be (like gerry said) with a Norvir booster.

This statement is unfortunately very true.  I feel like I am treating myself, at times.  The funny part is that the mention of Reyataz monotherapy being in trial stages was during a conversation about my Jaundice. (obviously being caused by the Reyataz / Norvir).  I am just hoping the combo I am taking will suppress the virus so I can take the time needed to find another doc. (the ones taking new patients have a long waiting list)   I also found out that my ID doc's specialty is TB, not HIV.

   *hiding my yellow eyes*