Monotherapy is a possibility of simplifying an antiretroviral therapy regimen

The European AIDS Clinical Society guidelines (November 2009, Version 5) are the first to propose to use ritonavir-boosted protease inhibitors (PI) as monotherapy. These treatment regimens may be the modality of choice for HIV-infected patients if nucleoside reverse transcriptase inhibitors (NRTI) are not tolerated or the ART regimen should be simplified.
The paper gives the results of the largest studies (MONET, OK04, OREY) dealing with switching from a standard ART regimen (2 NRTIs + PI) to PI monotherapy. The results of these studies provide strong evidence that ART regimen simplification to boosted PI monotherapy did not affect in the least therapeutic efficiency. After 48-96 weeks of monotherapy, treatment failure was recorded in 15-23% of patients; however, return to the previous therapeutic regime (addition of two former drugs from a NRTI group) allowed complete suppression of virus replication to be achieved again in 80% of cases. Development of PI resistance mutations in HIV was recorded only in single patients. PI monotherapy regimens were well tolerated, there were no adverse reactions associated with the use of NRTIs.

HIV infection, antiretroviral therapy, HIV monotherapy with protease inhibitors