title: Cobicistat: a new boost for the treatment of human immunodeficiency virus infection.
abstract: Ritonavir is commonly used as a pharmacokinetic booster for antiretroviral regimens in the management of human immunodeficiency virus infections. Limitations to ritonavir boosting include increased pill burden, adverse effects, and a wide range of clinically significant drug-drug interactions. Cobicistat is a new pharmacokinetic booster that is a selective inhibitor of cytochrome P450 3A, the main metabolizing pathway of several antiretrovirals. Cobicistat has been studied as a booster for elvitegravir, a second-generation integrase inhibitor, and protease inhibitors. Based on successful clinical trials, a new single-tablet regimen of elvitegravir, cobicistat, emtricitabine, and tenofovir has been approved for the management of treatment-naïve patients. Additional studies are underway investigating the safety and efficacy of cobicistat-boosted protease inhibitor regimens for both treatment-naïve and treatment-experienced patients. Cobicistat is well tolerated and may become a preferred booster for antiretroviral regimens, as it can be coformulated with several agents to create simpler regimens.
authors.affiliation: Department of Pharmacy Practice, Jefferson School of Pharmacy, Thomas Jefferson University, Philadelphia, Pennsylvania.
authors.forename: Bhavik M
authors.initials: BM
authors.lastname: Shah
authors.forename: Jason J
authors.initials: JJ
authors.lastname: Schafer
authors.forename: James
authors.initials: J
authors.lastname: Priano
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Squires
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002219:Carbamates / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D000069547:Cobicistat; D065692:Cytochrome P-450 CYP3A Inhibitors; D004338:Drug Combinations; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D019438:Ritonavir / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D013844:Thiazoles / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D019380:Anti-HIV Agents; D002219:Carbamates; D065692:Cytochrome P-450 CYP3A Inhibitors; D004338:Drug Combinations; D004791:Enzyme Inhibitors; D013844:Thiazoles; D000069547:Cobicistat; D019438:Ritonavir
keywords: GS-9350; HIV; antiretrovirals; booster; cobicistat; human immunodeficiency virus; pharmacokinetic enhancer; ritonavir