Considerations in selecting protease inhibitor therapy.
Over the past 10 years, highly active antiretroviral therapy that included a protease inhibitor has played a significant role in reducing morbidity and mortality among HIV-infected individuals. The early protease inhibitors were associated, however, with some significant limitations that posed major obstacles to their use--limited potency, difficult side effects, high regimen complexity and potential for cross-resistance. Important advances in the protease inhibitor class, including ritonavir boosting and the approval of two new protease inhibitors with the potential for once daily dosing, have led to simpler, better-tolerated protease-inhibitor therapy with the potential for improved efficacy, less toxicity and a reduced risk of the development of HIV resistance. Protease inhibitor characteristics and patient preferences should be considered in selecting the protease inhibitor that maximizes the opportunity for long-term efficacy and tolerability of highly active antiretroviral therapy.
Boyle
Brian A
BA
Weill Medical College of Cornell University, New York, NY 10021, USA. brianboylemd@yahoo.com
Elion
Richard A
RA
Moyle
Graeme J
GJ
Cohen
Calvin J
CJ
D004334:Drug Administration Schedule; D004347:Drug Interactions; D024882:Drug Resistance, Viral; D004356:Drug Storage; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D017410:Practice Guidelines as Topic
D017320:HIV Protease Inhibitors