Beyond efficacy: the impact of combination antiretroviral therapy on quality of life.
Combination antiretroviral therapy (ART) with two nucleoside reverse transcriptase inhibitors (NRTIs) plus a protease inhibitor (PI) significantly improved the prognosis of patients with HIV. Nevertheless, the usefulness of the first PIs was sometimes compromised by poor tolerability, high pill burden, frequent dosing, and food and fluid restrictions. Consequently, initial ART choices evolved toward simpler PI-sparing regimens incorporating non-nucleoside reverse transcriptase inhibitors or triple NRTIs. Because these PI-sparing alternatives also are imperfect, interest in PI-based approaches to initial therapy remains, especially in light of newer PIs that have a more favorable tolerability profile. The better safety and tolerability attributes of the newer PIs suggest that highly effective therapy can be administered while preserving patients' health-related quality of life. As long as the virologic activity of these newer PIs is comparable to that of existing options, differentiating features beyond efficacy are important in the choice of an appropriate treatment regimen for patients with HIV.
Sax
Paul E
PE
Brigham and Women's Hospital, Division of Infectious Diseases, 75 Francis Street, PBB-A-4, Boston, Massachusetts 02115, USA. psax@partners.org
Gathe
Joseph C
JC
D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000009:adverse effects*; D006304:Health Status; D006801:Humans; D008060:Lipodystrophy / Q000139:chemically induced*; D011788:Quality of Life; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects*; D011795:Surveys and Questionnaires
D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors