Switching from a Protease Inhibitor to an Integrase Inhibitor

Ritonavir-boosted protease inhibitors are effective and durable antiretroviral agents, but they often cause adverse metabolic effects such as dyslipidemia. Raltegravir, the first human immunodeficiency virus (HIV) integrase inhibitor, has been as effective as boosted protease inhibitors, with fewer metabolic side effects, and has emerged as an attractive alternative. Might substituting raltegravir for a boosted protease inhibitor in a suppressive antiretroviral regimen improve lipid profiles without sacrificing safety and efficacy?

Researchers conducted two identical international placebo-controlled trials (funded by the manufacturer of raltegravir) that involved 707 HIV-positive patients who exhibited undetectable viral loads while receivin…