title: Switching antiretroviral regimes for the treatment of HIV: safety implications.
abstract: BACKGROUND
  There are multiple reasons to switch from a virologically successful antiretroviral regimen. Some of them are related to toxicity. Lately, combination antiretroviral treatment (cART) switches have often been related to drug-drug interactions which may also eventually entail safety issues as well.
  
  
  METHODS
  The purpose of this review is to analyze causes of switching between virologically successful cART regimes related to safety issues. The most relevant papers were selected and summarized.
  
  
  CONCLUSIONS
  Switching cART has been a popular strategy to address safety issues throughout the antiretroviral era. The myriad of switching studies have paralleled the study and release into clinical practice of new antiretroviral drugs with different and often improved safety profiles. Most of them have been successful in improving antiretroviral toxicity while keeping HIV replication under control. However, it should be taken into account that, whenever a new drug is given, there is a possibility of new drug-related toxicity. Notwithstanding that, an increase in cART switching is foreseen, given the fact that we have a wide antiretroviral drug armamentarium and that people living with HIV are ageing and thus more prone to developing age-related co-morbidities whose therapies may entail new interactions and eventually new toxicities.
authors.affiliation: a Infectious Diseases Department , Hospitals Universitaris Arnau de Vilanova & Santa Maria, Universitat de Lleida, Institut de Recerca Biomèdica (IRB) de Lleida , Lleida , Spain.
authors.forename: Laia
authors.initials: L
authors.lastname: Utrillo
authors.affiliation: b Infectious Diseases Unit, Department of Internal Medicine , Hospital Universitari Joan XXIII, Universitat Rovira i Virgili, IISPV , Tarragona , Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: Vidal
authors.affiliation: a Infectious Diseases Department , Hospitals Universitaris Arnau de Vilanova & Santa Maria, Universitat de Lleida, Institut de Recerca Biomèdica (IRB) de Lleida , Lleida , Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Puig
authors.affiliation: a Infectious Diseases Department , Hospitals Universitaris Arnau de Vilanova & Santa Maria, Universitat de Lleida, Institut de Recerca Biomèdica (IRB) de Lleida , Lleida , Spain.
authors.forename: Pere
authors.initials: P
authors.lastname: Domingo
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004347:Drug Interactions; D057915:Drug Substitution / Q000009:adverse effects / Q000379:methods*; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D014779:Virus Replication / Q000187:drug effects
chemical_list: D019380:Anti-HIV Agents
keywords: Combination antiretroviral therapy; INsTI; NNRTI; NRTI; PI; safety; switching; toxicity