Considering change from Kaletra/Invirase to Prezista...

[jjmcm]

In 2005 I had to get medieval with my virus - Kaletra/Invirase, Fuzeon, and AZT.  It made me undetectable for the first time in ten years of treatment.  In December '07, we replaced the AZT with Truvada which I had been on previously.  Earlier this year I swapped out the Fuzeon with Isentress.  My VL stayed undectable both times. 

Now, my doctor has mentioned replacing the Kaletra/Invirase with Prezista.  I am nervous about this because I wonder if it is strong enough to replace both of them.  His logic is that we need to do it before I develop resistance to Kaletra.  I have read that once that happens Prezista only works in about 1/3 of the cases.

Has anyone else made this move successfully?   I appreciate the input.  Also, I am allergic to Bactrim, but my doctor says that he has not had problems associated with the sulfa in Prezista.

Thanks in advance.

--JJ

[Miss Philicia]

jjmcm: I did a lot of similar switching (I was on Kaletra/Invirase/Truvada then switched to Fuzeon/Prezista/Truvada and now am on Isentress/Prezista/Truvada) and I've not only maintained my lab numbers but they've continually improved (I didn't suppress my viral load for the first time, like you, until the Fuzeon phase, after over a decade of HIV meds)

At any rate, I don't know where you read this "1/3" thing about Prezista.  I've not heard that, nor have I read of complaints like this of others on that medication, either in "real life" where I live nor on this web forum.  Plus if you have diarrhea issues from that nasty Invirase/Kaletra combo it will improve immeasurably by switching to Prezista.

I'm actually surprised that your doctor didn't switch you earlier, because there was a couple of studies showing a better synergy in combining Fuzeon with Prezista as opposed to doing it later, and of course Prezista has been FDA approved now for two years, whereas Isentress is less than a year old.

[jjmcm]

Thanks for the response Philly.  I am just nervous about switching when something is working.  While Fuzeon saved my life, after 2 1/2 years I had enough of it.  I am glad the Isentress worked.

My doctor seems to have confidence that the Prezista will do the job.  The 1/3 thing is when you have previous experience with Kaletra and you develop significant resistance.  At that point, only about 1/3 have an effective response with Prezista.

That is the reason I would like to discontinue the Kaletra before I develop those resistance patterns and reduce the likelihood that the Prezista will work.  Are you allergic to Bactrim also?  No rash problems with the Prezista?

BTW, if you or anyone else has problems with diarrhea, I take Pure Green Power from Springboard4health.com and it has virtually eliminated it.  I take it twice a day with a little organic apple juice, black cherry juice, and aloe vera.  I had diarrhea for years and now take nothing except the green power.

Thanks...

 

[Miss Philicia]

My doctor seems to have confidence that the Prezista will do the job.  The 1/3 thing is when you have previous experience with Kaletra and you develop significant resistance.  At that point, only about 1/3 have an effective response with Prezista.
 

Again, I understand what you're trying to say, but I'm just not sure that it's accurate.  Can you show me a link to a study?  Where did you hear of this?

That is the reason I would like to discontinue the Kaletra before I develop those resistance patterns and reduce the likelihood that the Prezista will work.  Are you allergic to Bactrim also?  No rash problems with the Prezista?

Huh?  Are you sure that you're not already resistant to the PI class of meds?  That's generally why they put one on Prezista.

And yes I got a rash and discontinued Bactrim, but that happened over a decade before I went on Prezista.  The sulfa in Prezista did not cause me any reaction.