Lopinavir/Ritonavir Monotherapy Reconsidered in a New Setting

Treatment success was seen in 87% of patients who switched from a failing first-line regimen to lopinavir/r monotherapy, but 29% of those patients continued to experience low-level viremia.

Lopinavir/ritonavir monotherapy has been associated with lower rates of virologic suppression than combination antiretroviral therapy (ART), as well as higher rates of low-level viremia (JW AIDS Clin Care Mar 24 2008), protease inhibitor (PI) resistance (JW AIDS Clin Care Jul 13 2009), and viral relapse within the central nervous system (JW AIDS Clin Care Sep 20 2010). Based on these and other findings, current U.S. guidelines discourage the use of boosted-PI monotherapy for either initial ART or regimen simplification. However, in many resource-limited settings, viral-load monitoring is unavailable and identification of first-line treatment failure is delayed, potentially resulting in the development of extensive nucleoside resistance. In …

Reviewing Author

Holly Rawizza, MD

Lopinavir/Ritonavir Monotherapy Reconsidered in a New Setting

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Reviewing Author