Modifying Antiretroviral Therapy in Virologically Suppressed HIV-Infected Patients
Supporting Assets
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 |
| Decrease in lipid parameters | |
Boosted PI |
| ||
CNS toxicity |
| Decreased of central nervous system adverse events | |
Dyslipidemia |
| ↓ TC, LDL | |
|
| ||
| ↓ 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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Keywords: Switch Strategies