[Meta-analysis of the effectiveness of the strategy of monotherapy with boosted protease inhibitors in HIV+ patients].
BACKGROUND
The objective of this study is to analyse the available evidence regarding the effectiveness of the strategy of induction maintenance with boosted protease inhibitors with ritonavir in adult HIV patients as compared to conventional treatment.


METHODS
We performed a meta-analysis of randomised controlled trials in HIV patients to compare the efficacy of a monotherapy strategy of boosted protease inhibitors as compared with conventional antiretroviral therapy. The literature search was conducted in PubMed, EMBASE (September 1999-September 2009) and in conference abstracts of the last 5 years. The Odds Ratio of treatment failure and their 95% confidence intervals were calculated. To combine the results of individual studies selected, a fixed effects model based on the Mantel-Haenszel method or random effects was used, depending on whether or not the results were heterogeneous.


RESULTS
Initially a total of 1510 publications were found, of which just 8 studies met the criteria for inclusion in the meta-analysis. The combined Odds Ratio of the 8 studies is 1.39 (95% CI 1.02-1.90) for the treatment group with conventional antiretroviral treatment, but with a confidence interval close to the limits of statistical non-significance.


CONCLUSIONS
The results of the combined effectiveness analysis in the meta-analysis found no significant differences between the conventional strategy and monotherapy. This strategy is considered recommended (level A evidence) in patients with no history of previous failure of protease inhibitor, with undetectable plasma viral load and signs or symptoms of nucleoside/nucleotide toxicity.
Saez de la Fuente
J
J
Servicio de Farmacia, Hospital Infanta Leonor, Madrid, España.
Such Díaz
A
A
Sánchez Gil
C
C
Esteban Alba
C
C
Escobar Rodríguez
I
I
D006679:HIV Seropositivity / Q000188:drug therapy*; D006801:Humans; D011480:Protease Inhibitors / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
D011480:Protease Inhibitors