Agents Used in Antiretroviral Therapy
Summary
- Because they are metabolized by cytochrome P450 3A4 enzymes, PIs (except nelfinavir) can be pharmacologically boosted
- Boosting (with ritonavir or cobicistat) results in higher trough concentrations and/or longer half-lives, lower pill burden, and improved efficacy, but increases the potential for significant drug–drug interactions
- Virologic failure of boosted PIs in first-line therapy has been associated with little or no emergence of major PI mutations[Eron 2006; Molina 2008; Ortiz 2008; Walmsley 2008]
Atazanavir
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