Protease inhibitor monotherapy as a maintenance regimen: are we edging towards acceptance?

"An entire session at the 12th European AIDS Conference was devoted to trials of different ritonavir-boosted protease inhibitors (PI/r) used as the sole drug in an antiretroviral regimen.

"Several trials of protease inhibitor therapy have produced long-lasting viral suppression statistically non-inferior to two-class therapy. Most successful trials have switched patients to PI monotherapy as a maintenance regimen after starting with combination therapy but some success continues to be seen in trials using monotherapy from the start.

"The failure of a trial using a single protease inhibitor as initial regimen, however, was a warning that it is possible to take this approach too far, and doubts remain about the long-term safety of the approach in terms of its ability to suppress HIV in places like the central nervous system and genital mucosa."

Read more in Aidsmap, November 16, 2009.