When Is a Switch from a Protease Inhibitor to Raltegravir Reasonable?

Such switches are best avoided in patients with previous treatment failure or documented nucleoside resistance.

Raltegravir, the first HIV integrase inhibitor, has proven to be a very versatile antiretroviral agent, with demonstrated value in both treatment-naive and treatment-experienced HIV-infected patients. Its overall efficacy, lack of drug interactions, and excellent tolerability have made it a potentially appealing option for patients looking to switch away from protease inhibitors (PIs). Three studies published in 2010 illustrate when such a switch may be reasonable — and when it is not.

In the SWITCHMRK studies, patients with full virologic suppression on lopinavir/ritonavir-based treatment were randomized to either remain on lopinavir/r or switch that drug to raltegravir (JW AIDS Clin Care Feb 12 2010). Switching to raltegravir was found to …

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Charles B. Hicks, MD

Disclosures

Consultant / Advisory boardGilead Sciences; ViiV; Merck

RoyaltiesUpToDate, Inc.

Grant / Research supportNIH; Department of Health and Human Services

Charles B. Hicks, MD

Disclosures

Consultant / Advisory boardGilead Sciences; ViiV; Merck

RoyaltiesUpToDate, Inc.

Grant / Research supportNIH; Department of Health and Human Services

When Is a Switch from a Protease Inhibitor to Raltegravir Reasonable?

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