title: [Boosted protease inhibitor monotherapy in HIV-infected patients: results of a study in a real life setting].
abstract: BACKGROUND
  Boosted protease inhibitor monotherapy may offer antiviral efficacy while reducing drug interactions, costs and toxicity. The aim of this study was to assess the efficacy of darunavir/ritonavir (DRV/r) and lopinavir/ritonavir (LPV/r) monotherapy in a real life setting.
  
  
  METHODS
  A retrospective analysis of all HIV infected patients, who had initiated DRV/r or LPV/r monotherapy, was performed. Patients whose HIV viral load had remained undetectable for at least two consecutive follow-up visits and who had no neurocognitive disorder or hepatitis B co-infection, were included.
  
  
  RESULTS
  Sixty patients were included. The median (IQR) time to follow-up was 66 (33-118) weeks. The proportions (CI95%) of patients with virological failure were 6.3% (1.7- 20.2) and 25.0% (12.7-43.4), respectively, in the DRV/r and LPV/r groups (p= 0.0424). The proportions (CI95%) of patients with therapeutic success were 90.6% (80.5-100) in the DRV/r group and 60.7% (42.6-78.8) in the LPV/r group (p=0.0063). No protease inhibitor mutations were detected. During the follow-up, 6 patients with dyslipidemia normalized their lipid values. The median monthly cost was 410 (IQR 242-416) euros per person lower for the monotherapy than for the combined antiretroviral therapy.
  
  
  CONCLUSIONS
  Boosted protease inhibitor monotherapy was effective in a real life setting. This study showed differences in favour of DRV/r as compared with LPV/r in terms of therapeutic success; however prospective studies are needed to confirm these results. Finally, although this study was not specifically designed to detect benefits in terms of costs and lipid profile, it shows evidence of a positive impact of monotherapy in these fields.
authors.affiliation: Nicolás Di Benedetto, Unidad de Enfermedades Infecciosas. Hospital Universitario y Politécnico La Fe. Av. Fernando Abril Martorell, 106. 46026. Valencia, Spain. dibenedettonicolas@gmail.com.
authors.forename: Nicolás
authors.initials: N
authors.lastname: Di Benedetto
authors.forename: Marta
authors.initials: M
authors.lastname: Montero-Alonso
authors.forename: Marino
authors.initials: M
authors.lastname: Blanes
authors.forename: José
authors.initials: J
authors.lastname: Lacruz
authors.forename: Sandra
authors.initials: S
authors.lastname: Cuellar
authors.forename: Eva
authors.initials: E
authors.lastname: Calabuig
authors.forename: José
authors.initials: J
authors.lastname: López
authors.forename: Miguel
authors.initials: M
authors.lastname: Salavert
mesh_terms: D000328:Adult; D000368:Aged; D000069454:Darunavir / Q000627:therapeutic use; D004338:Drug Combinations; D024882:Drug Resistance, Viral / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D015497:HIV-1 / Q000235:genetics; D006801:Humans; D061466:Lopinavir / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D012189:Retrospective Studies; D019438:Ritonavir / Q000627:therapeutic use
chemical_list: D004338:Drug Combinations; D017320:HIV Protease Inhibitors; D061466:Lopinavir; D019438:Ritonavir; D000069454:Darunavir