Benefits and concerns of simplification strategies in HIV-infected patients

Eugènia Negredo, Anna Bonjoch, Bonaventura Clotet

Research output: Contribution to journalArticleResearchpeer-review

34 Citations (Scopus)

Abstract

Highly active antiretroviral therapies (HAART) provide sustained viral control in most patients, but many of these regimens are restricted by complex dosing, drug-drug interactions and toxicities. Numerous strategies of simplified treatment have been explored in order to improve patient quality of life and adherence to treatment, as well as to manage drug-related toxicities while maintaining viral suppression. The first simplification strategy involved switching from protease inhibitors (PIs) to non-nucleoside reverse transcriptase inhibitors (NNRTIs), with an additional benefit on lipid metabolism. The development of once-daily drugs or co-formulated combinations has successfully been used to further simplify treatment. However, studies assessing triple nucleoside regimens have shown a higher frequency of viral failure in comparison with standard HAART, mainly in patients with previous sequential suboptimal treatments. Finally, NRTI-sparing approaches, consisting of NNRTI + PI combinations or monotherapies with boosted PIs, are alternatives to avoid NRTI-related mitochondrial toxicities. An accurate analysis of each patient's history will be necessary in each case to determine whether a simplification strategy is appropriate. © 2006 Oxford University Press.
Original languageEnglish
Pages (from-to)235-242
JournalJournal of Antimicrobial Chemotherapy
Volume58
DOIs
Publication statusPublished - 1 Aug 2006

Keywords

  • Antiretroviral therapy
  • Efficacy
  • HIV-infection
  • Safety
  • Simplification strategies

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