There were several studies testing new ways to use old drugs either in combination or alone. Two studies tested whether we can simplify therapy from a traditional combination of agents to a single drug. There were an updated report on the "OK Study" which took patients on combination therapy and either left them on this treatment or switched them to lopinavir/ritonavir (Kaletra™) alone. Although the field moved away from single drug treatment many years ago, lopinavir/ritonavir is a unique option because it is very potent and rarely allows for drug resistance to develop. In fact, a small study reported last year showed that some people experienced complete viral suppression when taking this medication as single drug therapy. In the current study the majority of subjects did maintain viral suppression when continued on lopinavir/ritonavir alone although there were three individuals out of approximately 20 that did experience viral rebound. While this strategy holds some promise, it is a very small study and probably requires further research before it should be considered for routine care.
In a related study, subjects on antiretroviral therapy with undetectable viral loads were switched to lone therapy with once daily atazanavir (Reyataz™) with ritonavir. This was also a very preliminary report but showed early promise for this strategy. Nevertheless, more experience and clinical research is needed before this should be seriously considered in the clinic.
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