title: [Positioning of lopinavir/ritonavir in antiretroviral treatment schemes].
abstract: Lopinavir/ritonavir (LPV/r) was approved for use in the treatment of human immunodeficiency virus (HIV) infection in 2001 and is the protease inhibitor that has been most widely studied in clinical trials. Despite the time interval since its approval, all the evidence accumulated in the last 14 years indicates that LPV/r continues to occupy an important position among antiretroviral drugs. Firstly, LPV/r plus 2 nucleoside/nucleotide analogs is still considered a good option for initial antiretroviral therapy (ART). Secondly, numerous studies have evaluated the efficacy and safety of new initial ART strategies based on LPV/r in dual therapy. The results obtained suggest that LPV/r plus lamivudine (3TC) or raltegravir can be as effective in initial ART as standard triple therapy and justify their consideration as alternative regimens in this scenario. Thirdly, LPV/r is a pioneer drug, as well as being the agent with the largest amount of evidence from clinical trials on simplification to monotherapy (LPV/r) or dual therapy (LPV/r + 3TC). Lastly, LPV/r is highly useful is special situations. It has a low risk of liver toxicity in patients with chronic liver disease, its use is preferred in the treatment of patients with HIV-2, and it is safe and effective in preventing vertical HIV transmission.
authors.affiliation: Unidad de Enfermedades Infecciosas, Hospital Universitario Reina Sofía, Córdoba, España.
authors.forename: Ángela
authors.initials: Á
authors.lastname: Camacho
authors.affiliation: Unidad de Enfermedades Infecciosas, Hospital Universitario Reina Sofía, Córdoba, España. Electronic address: ariveror@gmail.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Rivero
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D004338:Drug Combinations; D015658:HIV Infections / Q000188:drug therapy*; D019428:HIV Integrase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D017320:HIV Protease Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D061466:Lopinavir / Q000008:administration & dosage / Q000627:therapeutic use*; D055118:Medication Adherence; D015201:Meta-Analysis as Topic; D015337:Multicenter Studies as Topic; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D012306:Risk; D019438:Ritonavir / Q000008:administration & dosage / Q000627:therapeutic use*; D013810:Therapeutic Equivalency; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D004338:Drug Combinations; D019428:HIV Integrase Inhibitors; D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors; C558899:lopinavir-ritonavir drug combination; D061466:Lopinavir; D019438:Ritonavir
keywords: Antiretroviral therapy; HIV infection; Infección por el VIH; Lopinavir/ritonavir; Tratamiento antirretroviral