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High Lipids few Options Posted: Jun 11, 2007 QUESTION: I have a patient who is treatment experienced. 2003 GART detected Q151M plus L10I/R/V K20R D30N M36I L63P and N88D He became non detectable on LPVrtv 3 BID APV 1200 BID TDF and 3TC. When Agenerase was discontinued I switched to Fos APV and he remneianed non detectable for 3 years Fos APV stopped 6 months ago and he remains non detectable on LPV 600 BID RTV 150 BID TDF 300/D and Emtriva 200 per day. Triglycerides remain at 900 in spite of intensive statin and Lopid therapy. I am considering replacing the Kaletra with either boosted ATV or Darunavir. What do you think?


RESPONSE FROM: A switch to these alternative PIs may reduce the triglycerides and should not compromise potency. I guess I would wonder whether the patient needs to take 3 Kaletra tablets BID instead of the usual 2 BID. The standard dose of Kaletra may provide viral suppression and should lead to a reduction in TGs. Fish oil at doses of 4-6 grams a day may also help but I suspect the problem is the high dose of ritonavir the patient is taking. DW

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