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Ritonavir has proven to be invaluable as a pharmacokinetic booster for other antiretrovirals (especially PIs), but it does have some drawbacks, including adverse events (particularly gastrointestinal toxicity and lipid perturbations), inconvenience (refrigeration requirement, large-capsule dosage form), relatively high cost, and nonspecific effects on the metabolism of other drugs. Moreover, if ritonavir is used to boost non–PI-based regimens, the risk of engendering PI resistance could be significant. Two potential alternatives were described at this year’s Retrovirus Conference.
Brian Kearney from Gilead Sciences presented data on GS-9350, a potent, irreversible inhibitor of the cytochrome P450 enzyme 3A (CYP3A) [Abstract 40]. The drug has…