Modifying Antiretroviral Therapy in Virologically Suppressed HIV-Infected Patients

  • Author: José R. Arribas, MD (More Info)
  • Section Editor: Eric S. Daar, MD
  • Editors in Chief: Joseph J. Eron, Jr., MD; Daniel R. Kuritzkes, MD
  • Last Reviewed: 10/18/21 (What's New)

Supporting Assets

Table 1 | Table 2

Table 1. Modifying ART to Increase Tolerability and/or Decrease Toxicity

Toxicity/Tolerability or Comorbidity of Concern

Offending Agent(s)

Switches Supported by Clinical Trial Evidence

Results

Bone health

Tenofovir DF

Improved bone parameters

Improvement in bone-specific alkaline phosphatase, osteocalcin, precollagen 1 N-terminal propeptide, type 1 collagen cross-linked C-telopeptide

 

Cardiovascular disease

Abacavir/lamivudine

 

Decrease in lipid parameters

Boosted PI

 

CNS toxicity

Efavirenz

 

Decreased of central nervous system adverse events

Dyslipidemia

Abacavir/lamivudine

 

↓ TC, LDL

Lopinavir/ritonavir

 

 

 

↓ TC, TGs, LDL, TC:HDL ratio

Ritonavir-boosted PI

↓ TC, TGs, LDL, non-HDL, TC:HDL ratio

↓ LDL, non-HDL

↓ TC, TGs, LDL, TC:HDL ratio

Lipid parameters decreased

Renal impairment

Tenofovir DF

Improved proximal tubular function endpoints

Weight gain

All INSTIs

Currently unproven; clinical trials ongoing

CNS, central nervous system; HDL, high-density lipoprotein LDL, low-density lipoprotein; TC, total cholesterol; TG, triglycerides.
*Currently being investigated in clinical trial.

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