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One of the hardest-learned lessons in HIV care is that treatment with only one'or even just two'antiretroviral drugs is ineffective and usually hastens the development of drug-resistant virus, limiting future treatment options. But researchers in Houston are challenging that treatment axiom with a new study, presented in September at the 43rd Interscience Conference on Antimicrobial Agents and Chemotherapy, that suggests that monotherapy with the protease inhibitor Kaletra might be effective. In an ongoing study of 22 treatment-naive volunteers taking only Kaletra, only one failed to achieve an undetectable HIV viral load after 24 weeks'eight of the original 30 study subjects initially enrolled were not included in the 24-week follow-up because they switched regimens or stopped taking Kaletra. No HIV genetic mutations conveying resistance to protease inhibitors were detected in the study group at the 24-week mark. The study will continue to follow the patients through 48 weeks of treatment, and further research is planned. If tests indicate that treatment with Kaletra alone can control HIV replication without the development of drug resistance, monotherapy might someday be an effective and affordable treatment option in poor countries and for participants in financially struggling AIDS Drug Assistance Programs, the study authors say.
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