Journal Article

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

C. L. Cooper, R. P. G. van Heeswijk, K. Gallicano and D. W. Cameron

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 36, issue 12, pages 1585-1592
Published in print June 2003 | ISSN: 1058-4838
Published online June 2003 | e-ISSN: 1537-6591 | DOI: https://dx.doi.org/10.1086/375233
A Review of Low-Dose Ritonavir in Protease Inhibitor Combination Therapy

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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.

Journal Article.  6888 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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