Question
If it only weigh 60 kg can I ease up on adherence?
3 October 2011. Related: Adherence, All topics, Changing treatment.
I weigh just over 60kg yet take the same doses of ARVs as people almost twice my size. I presume this means that my plasma and blood concentrations will be higher than the average person and the strict 24 hour dosing less critical?
Answer
Hi
Although it seems reasonable to think this, most drugs do not have this link between dose and weight.
So although two different size people take the same dose, this doesn’t always relate to drug levels that each person gets. Some drugs show no association between weight and drug levels.
It definitely is not a good basis for taking your meds on a more relaxed schedule. The flexibility you have for the different drugs will depend on the individual drugs you are taking.
Once your viral load is undetectable, most drugs are fine for most people to take one hour either side of the ideal time. For some drugs, most people are able to widen this to a couple of hours.
Some combinations include three drugs are metabilised slowly that all have good concentrations at the end of the dose period. One study with Atripla (efavirenz, tenofovir and FTC) called FOTO, suggested that this protection might be much stronger. In the FOTO study a small group of people missed two days meds each week without developing resistance.
The FOTO study was not large enough to prove the safety of this strategy. However, it is a good example of how flexibility might be greater for this combination once your viral load is undetectable.
Drug metabolism is complicated and individual. If you are worried about adherence, speak to your doctor about your particular combination. Also, whether other more flexible options are available that you could use.
Reference: Cohen C et al. The FOTO study: The 48 week extension to assess durability of the strategy of taking efavirenz, tenofovir and emtricitabine Five days On, Two days Off (FOTO) each week in virologically suppressed patients. 5th IAS Conference, 2009. Abstract MOPEB063.
http://library.iasociety.org/AbstractView.aspx?confID=2009&abstractId=3046
junk food (ie fast food which has high sugar and salt content and which is usually fried) makes you crave junk food. It gives you a quick rush and then leave your food feeling like it hasn’t eaten. HIV drugs have not been linked to an increase in the use of junk food.
Perhaps if you have more energy after starting treatment this has increased your appetite. Most people report an increase in weight during the first six months on treatment.
Modifying the type of food you eat to a more healthy diet will be better for your health in the long term.
i have started treatment and the drugs im taking they make me crave junk food, my worry is they are not healthy and wont they affect my system and health cause i eat too much? the last time weight 52.6.