TY - JOUR
T1 - Boosted protease inhibitor monotherapy in HIV-infected adults
T2 - Outputs from a pan-European expert panel meeting
AU - Arribas, José R.
AU - Doroana, Manuela
AU - Turner, Dan
AU - Vandekerckhove, Linos
AU - Streinu-Cercel, Adrian
N1 - Funding Information:
This clinical review reflects the detailed discussion and opinions of the authors on data and literature reviewed at an expert panel meeting on the use of ritonavir-boosted protease inhibitor monotherapy, held in Bucharest, Romania in November 2011. The meeting was supported by Janssen Pharmaceutica N.V., however the content of this paper does not necessarily reflect the opinions of the meeting sponsor. Medical writing support was provided by Karen Pilgram, Gardiner-Caldwell Communications (funded by Janssen Pharmaceutica N.V.), who developed the first draft of the manuscript based on the debate and discussions during the meeting.
Funding Information:
Professor JR Arribas has received advisory fees, speaker fees and grant support from the following sources: Abbott, Bristol-Myers Squibb, Gilead, Janssen, MSD, Tibotec and ViiV Healthcare. Dr M Doroana has received speaker fees from different sources: Gilead, Roche, Janssen and Abbott. Dr D Turner has received honoraria from the following sources: Abbott, Biotis, GlaxoSmithKline, Janssen, MSD, Neopharm, Roche and Schering-Plough. Professor L Vandekerckhove has received advisory fees, speaker fees and grant support from the following sources: Gilead, Janssen, MSD, Bristol-Myers Squibb, Pfizer and ViiV Healthcare. Professor A Streinu Cercel has relationships with all major pharmaceutical companies but without any specific arrangements.
PY - 2013/1/24
Y1 - 2013/1/24
N2 - While the introduction of combination highly active antiretroviral therapy (HAART) regimens represents an important advance in the management of human immunodeficiency virus (HIV)-infected patients, tolerability can be an issue and the use of several different agents may produce problems. The switch of combination HAART to ritonavir-boosted protease inhibitor (PI) monotherapy may offer the opportunity to maintain antiviral efficacy while reducing treatment complexity and the risks of toxicity. Current European AIDS Clinical Society (EACS) guidelines recognise ritonavir-boosted PI monotherapy with twice-daily lopinavir/ritonavir or once-daily darunavir/ritonavir as a possible option in patients who have intolerance to nucleoside reverse transcriptase inhibitors, or for treatment simplification. Clinical trials data for PI boosted monotherapy are encouraging, showing substantial efficacy in the majority of patients; however, further data are required before this approach can be recommended as a routine treatment. Available data indicate that the most suitable candidates for the use of boosted PI monotherapy are long-term virologically suppressed patients who have demonstrated good adherence to antiretroviral therapy, who do not have chronic hepatitis B, have no history of treatment failure on PIs and are able to tolerate low-dose ritonavir.
AB - While the introduction of combination highly active antiretroviral therapy (HAART) regimens represents an important advance in the management of human immunodeficiency virus (HIV)-infected patients, tolerability can be an issue and the use of several different agents may produce problems. The switch of combination HAART to ritonavir-boosted protease inhibitor (PI) monotherapy may offer the opportunity to maintain antiviral efficacy while reducing treatment complexity and the risks of toxicity. Current European AIDS Clinical Society (EACS) guidelines recognise ritonavir-boosted PI monotherapy with twice-daily lopinavir/ritonavir or once-daily darunavir/ritonavir as a possible option in patients who have intolerance to nucleoside reverse transcriptase inhibitors, or for treatment simplification. Clinical trials data for PI boosted monotherapy are encouraging, showing substantial efficacy in the majority of patients; however, further data are required before this approach can be recommended as a routine treatment. Available data indicate that the most suitable candidates for the use of boosted PI monotherapy are long-term virologically suppressed patients who have demonstrated good adherence to antiretroviral therapy, who do not have chronic hepatitis B, have no history of treatment failure on PIs and are able to tolerate low-dose ritonavir.
UR - http://www.scopus.com/inward/record.url?scp=84872687219&partnerID=8YFLogxK
U2 - 10.1186/1742-6405-10-3
DO - 10.1186/1742-6405-10-3
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AN - SCOPUS:84872687219
VL - 10
JO - AIDS Research and Therapy
JF - AIDS Research and Therapy
SN - 1742-6405
IS - 1
M1 - 3
ER -
