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Expert Review

6th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2011)

HIV 2011

Chapter 1: Protease Inhibitors after 15 Years: Report from the IAS

Dr. Jean-Guy Baril
Clinique Médicale du Quartier Latin, Montreal, QC
Dr. Jason Brunetta
Maple Leaf Medical Clinic, Toronto, ON

Rome – In 1996, a protease inhibitor (PI)-based antiretroviral combination led to the first opportunity for long-term survival for most patients living with human immunodeficiency virus (HIV). On the 15th anniversary of that breakthrough, PIs are no longer a mandatory component of an effective antiretroviral regimen, but they remain an important and reliable option in HIV control. As they are among the most potent antiretroviral agents, PIs remain a reasonable choice in a wide variety of clinical scenarios, including first-line treatment. Although some of the initially introduced PIs remain available, the common PIs in most formularies are ritonavir-boosted atazanavir (ATV/r), darunavir (DRV/r), and lopinavir (LPV/r). Relative to first generation PIs, these have few dosing restrictions, a low pill burden, and less relative risk of adverse events. Despite the broad experience with all of these agents, optimal use of PIs remains a dynamic exploration of relative strengths and weaknesses, particularly in the context of an aging HIV-infected population. This update assembles key studies on PIs from the 2011 IAS meeting.

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