title: [Darunavir/cobicistat monotherapy. Experience in a tertiary hospital].
abstract: OBJECTIVE
  Ritonavir-boosted protease inhibitor (IP/r) monotherapy: darunavir/ritonavir (DRV/r) or lopinavir/ritonavir (LPV/r) monotherapy is only provided in the major treatment guidelines in pretreated patients to prevent toxicity associated with nucleoside/nucleotide reverse transcriptase inhibitor (NRTI), reduce costs and simplify antiretroviral treatment. To start IP/r monotherapy, according to GESIDA guidelines 2016, patients need to meet the following criteria: absence of chronic hepatitis B, plasma viral load <50 copies/ mL for at least 6 months and absence of protease inhibitors mutations or previous virologic failures to IP/r. Currently, there are no studies that evaluate the efficacy and safety of darunavir/cobicistat (DRV/COBI) monotherapy.
  
  
  METHODS
  This prospective study analyzed pretreated HIV patients with DRV/r monotherapy that were switched to DRV/COBI monotherapy. The aim of the study is to describe the effectiveness and safety of the DRV/COBI monotherapy.
  
  
  RESULTS
  Seventy-eight patients were evaluated. Patients had a median of 31.29 months of DRV/r monotherapy before DRV/COBI monotherapy. Nine of the 78 patients developed "blips" (plasma viral load: 50-200 copies/ml) and four patients had plasma viral load ≥200 copies/mL. An 83.3% (65/78) of the patients remained with undetectable plasma viral load. As for safety, there were no significant differences in lipid profile, liver function (transaminases) and renal function between DRV/r and DRV/COBI monotherapy.
  
  
  CONCLUSIONS
  DRV/COBI monotherapy seems to be effective and safe (lipid profile, liver and kidney function). However, it will be necessary to design specific studies comparing DRV/r vs DRV/COBI monotherapy to confirm these results.
authors.forename: L
authors.initials: L
authors.lastname: Yunquera-Romero
authors.affiliation: Rocío Asensi-Díez, Servicio de Farmacia. Hospital Regional Universitario de Málaga. Avenida de Carlos Haya s/n. CP.29010. Málaga, Spain. rocio.asensi.sspa@juntadeandalucia.es.
authors.forename: R
authors.initials: R
authors.lastname: Asensi-Díez
authors.forename: J C
authors.initials: JC
authors.lastname: Del Rio-Valencia
authors.forename: I
authors.initials: I
authors.lastname: Muñoz-Castillo
authors.forename: M A
authors.initials: MA
authors.lastname: Castaño-Carracedo
mesh_terms: D000328:Adult; D000069547:Cobicistat / Q000009:adverse effects / Q000627:therapeutic use*; D000069454:Darunavir / Q000009:adverse effects / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D017320:HIV Protease Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D061466:Lopinavir / Q000627:therapeutic use; D008297:Male; D011446:Prospective Studies; D019438:Ritonavir / Q000627:therapeutic use; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D004338:Drug Combinations; D017320:HIV Protease Inhibitors; D061466:Lopinavir; D000069547:Cobicistat; D019438:Ritonavir; D000069454:Darunavir