Skip Navigation LinksHome > November 2008 - Volume 3 - Issue 6 > Protease inhibitor therapy in resource-limited settings
Current Opinion in HIV & AIDS:
doi: 10.1097/COH.0b013e3283139147
HIV protease inhibitors: Edited by Jon Schapiro and John Erickson

Protease inhibitor therapy in resource-limited settings

Elliott, Julian Ha,b,c; Pujari, Sanjayd,e

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Purpose of review: The use of protease inhibitors in resource-limited settings will increase in coming years as HIV treatment cohorts mature. We review data available to guide the expanded use of protease inhibitors in these settings.

Recent findings: The safety and effectiveness of protease inhibitors may be affected by the context of their use, yet limited data exist regarding the use of these agents in resource-limited settings in either first or subsequent regimens. Critically, data are needed regarding optimal regimens at time of first-line nonnucleoside reverse transcriptase inhibitor-based regimen failure. A number of alternative strategies are being investigated, including dual-boosting, monotherapy and dose reduction. Despite recent progress cost, storage requirements, drug interactions and formulation continue to hinder the use of protease inhibitors, particularly for children.

Summary: Protease inhibitors are the core component of second-line therapy in resource-limited settings and are used in specific situations in first-line therapy. Use of second-line regimens has been more diverse than first line, but WHO has recently prioritized regimens containing lopinavir/ritonavir or ritonavir-boosted atazanavir. As use of protease inhibitors in resource-limited settings increases evidence needs to be accrued to guide further expanded use.

© 2008 Lippincott Williams & Wilkins, Inc.


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