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Expert Review

13th European AIDS Clinical Society (EACS) Conference

HIV 2011

Chapter 1: Protease Inhibitors in Nucs-Sparing Strategies: Report from the EACS

Dr. Patrice Junod
Clinique Médicale l’Actuel, Montreal, QC
Dr. M. John Gill
Southern Alberta HIV Clinic, Calgary, AB

Belgrade – Antiretroviral combinations that do not include nucleoside reverse transcriptase inhibitors (NRTIs; ‘nucs’), so-called nucs-sparing regimens, were once largely tested as a strategy to avoid mitochondrial toxicities. However, this approach now offers promise in reducing some of the specific age-related morbidities exacerbated by NRTIs, such as progressive renal impairment. It could also save costs. At the 13th European AIDS Clinical Society (EACS) meeting, a variety of new information was presented on the role of protease inhibitors (PIs) in nucs-sparing regimens. Whether combined with another PI or a drug from another class, such regimens were reported as already being in routine use at some centres even while clinical studies attempt to define which patients are the best candidates. Overall, the data presented suggested that nucs-sparing is a reasonable and appropriate option in at least some select patient groups for whom NRTIs are relatively contraindicated. As more data become available, this approach may beextended to the larger HIV population, including those who are treatment naive.

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