A Review of Low-Dose Ritonavir in Protease Inhibitor Combination Therapy | Zendy

Curtis Cooper | Zendy; Rolf P. G. van Heeswijk | Zendy; Keith Gallicano | Zendy; D. William Cameron | Zendy

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A Review of Low-Dose Ritonavir in Protease Inhibitor Combination Therapy

Author(s) -

Curtis Cooper,

Rolf P. G. van Heeswijk,

Keith Gallicano,

D. William Cameron

Publication year - 2003

Publication title -

clinical infectious diseases

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 3.44

H-Index - 336

eISSN - 1537-6591

pISSN - 1058-4838

DOI - 10.1086/375233

Subject(s) - ritonavir , indinavir , saquinavir , lopinavir , medicine , pharmacology , protease inhibitor (pharmacology) , bioavailability , protease , pharmacokinetics , virology , viral load , enzyme , human immunodeficiency virus (hiv) , antiretroviral therapy , chemistry , biochemistry

The pharmacokinetics of protease inhibitors center around the microsomal enzyme cytochrome P-450 3A4. As a potent inhibitor of this enzyme, ritonavir can increase the bioavailability and half-life of coadministered protease inhibitors. Evidence suggests that increased exposure to protease inhibitors is clinically relevant. Antiretroviral treatment with low-dose ritonavir-boosted lopinavir, indinavir, and saquinavir has durable virological activity and shows impressive immune reconstitution. Although tolerable in most cases, gastrointestinal side effects, hepatotoxicity, and blood lipid abnormalities remain relevant issues. Additional study will elucidate the advantages and disadvantages of twice-daily, low-dose ritonavir-boosted regimens and determine whether once-daily regimens based on this principle will have a lasting role in clinical practice.

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