title: [Efficacy of initial antiretroviral therapy based on lopinavir/ritonavir plus 2 nucleoside/nucleotide analogs in patients with human immunodeficiency virus type 1 infection].
abstract: Triple combination regimens consisting of lopinavir/ritonavir (LPV/r) plus 2 nucleoside/nucleotide analogs continue to be a valid option in initial antiretroviral therapy. Other protease inhibitors boosted with ritonavir (and in future with cobicistat) have been introduced, as well as other non-nucleoside analogs (rilpivirin) and 3 integrase inhibitors. None of the new regimens have shown superiority over LPV/r or comparisons are lacking. Therefore, regimens including LPV/r continue to be recommended as initial first-line or alternative strategies in most treatment guidelines. Dual combinations with LPV/r (plus raltegravir or lamivudine) are described in another article and can provide a similar response rate to triple combinations, better tolerance, and an improved cost-efficacy ratio, both for initial therapy and in simplification strategies. In contrast, LPV/r or darunavir/r monotherapy does not seem an acceptable option in treatment-naïve patients and is becoming increasingly less acceptable in simplification strategies.
authors.affiliation: Servicio de Infecciones, Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, España.
authors.forename: Laura
authors.initials: L
authors.lastname: Zamora
authors.affiliation: Servicio de Infecciones, Hospital Clínic-IDIBAPS, Universidad de Barcelona, Barcelona, España. Electronic address: gatell0@attglobal.net.
authors.forename: José M
authors.initials: JM
authors.lastname: Gatell
mesh_terms: D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use; D017326:Clinical Trials, Phase III as Topic; D004311:Double-Blind Method; D004338:Drug Combinations; D024882:Drug Resistance, Viral; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D015497:HIV-1 / Q000187:drug effects; D006801:Humans; D061466:Lopinavir / Q000494:pharmacology / Q000627:therapeutic use*; D015337:Multicenter Studies as Topic; D016032:Randomized Controlled Trials as Topic; D018894:Reverse Transcriptase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D019438:Ritonavir / Q000494:pharmacology / Q000627:therapeutic use*; D013810:Therapeutic Equivalency
chemical_list: D019380:Anti-HIV Agents; D004338:Drug Combinations; D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors; C558899:lopinavir-ritonavir drug combination; D061466:Lopinavir; D019438:Ritonavir
keywords: AIDS; Antiretroviral therapy; Antirretrovirales; HIV; Inhibidores de la proteasa; Lopinavir; Protease inhibitors; Ritonavir; Sida; VIH