Biomaterial Database

Protease inhibitor-based antiretroviral therapy in treatment-naive HIV-1-infected patients: the evidence behind the options. 2010

Susanna Naggie, and Charles Hicks

Division of Infectious Diseases, Duke University Medical Center, Durham, NC 27710, USA. naggi001@mc.duke.edu

The introduction of protease inhibitors (PIs) to HIV treatment combinations in 1996 has significantly reduced morbidity and mortality due to HIV infection. Since the 1990s, multiple PIs have been approved, with several boosted PI regimens recognized as first-line regimens in antiretroviral therapy (ART)-naive patients. While the current guidelines recommend non-nucleoside reverse transcriptase inhibitor-, PI- and integrase inhibitor-based regimens as equal alternatives in ART-naive patients, there are clearly selected patients for whom PI-based regimens appear to be the best option because of specific toxicity or dosing issues. Due to the multiple options of therapy available for ART-naive patients, providers initiating PI-based ART can individualize therapy based on patient characteristics and needs, including pre-treatment resistance, drug-drug interactions, adverse effect profiles and co-morbid conditions. Here, we discuss the current recommendations and recent guidelines, and the evidence available for various PI-based ART regimens in treatment-naive patients. We also discuss adverse effects and the use of PIs in special circumstances.

UI	MeSH Term	Description	Entries
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015497	HIV-1	The type species of LENTIVIRUS and the etiologic agent of AIDS. It is characterized by its cytopathic effect and affinity for the T4-lymphocyte.	Human immunodeficiency virus 1,HIV-I,Human Immunodeficiency Virus Type 1,Immunodeficiency Virus Type 1, Human
D015658	HIV Infections	Includes the spectrum of human immunodeficiency virus infections that range from asymptomatic seropositivity, thru AIDS-related complex (ARC), to acquired immunodeficiency syndrome (AIDS).	HTLV-III Infections,HTLV-III-LAV Infections,T-Lymphotropic Virus Type III Infections, Human,HIV Coinfection,Coinfection, HIV,Coinfections, HIV,HIV Coinfections,HIV Infection,HTLV III Infections,HTLV III LAV Infections,HTLV-III Infection,HTLV-III-LAV Infection,Infection, HIV,Infection, HTLV-III,Infection, HTLV-III-LAV,Infections, HIV,Infections, HTLV-III,Infections, HTLV-III-LAV,T Lymphotropic Virus Type III Infections, Human
D017320	HIV Protease Inhibitors	Inhibitors of HIV PROTEASE, an enzyme required for production of proteins needed for viral assembly.	HIV Protease Inhibitor,Inhibitor, HIV Protease,Inhibitors, HIV Protease,Protease Inhibitor, HIV,Protease Inhibitors, HIV
D017410	Practice Guidelines as Topic	Works about directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.	Clinical Guidelines as Topic,Best Practices,Best Practice
D023241	Antiretroviral Therapy, Highly Active	Drug regimens, for patients with HIV INFECTIONS, that aggressively suppress HIV replication. The regimens usually involve administration of three or more different drugs including a protease inhibitor.	Combination Antiretroviral Therapy,HAART,Highly Active Antiretroviral Therapy,Antiretroviral Therapies, Combination,Antiretroviral Therapy, Combination,Combination Antiretroviral Therapies,Therapies, Combination Antiretroviral,Therapy, Combination Antiretroviral