Abstract
The advent of combination antiretroviral therapy has led to significant improvement in the care of HIV-infected patients. Originally designed as a protease inhibitor (PI), ritonavir is currently exclusively used as a pharmacokinetic enhancer of other protease inhibitors, predominantly due to ritonavir's potent inhibition of the cytochrome P450 3A4 isoenzyme. Ritonavir-boosting of PIs decrease pill burden and frequency of dosing. Boosted PIs are recommended for first-line therapy in treatment and play a key role in the management of treatment-experienced patients. Potential problems associated with PIs include metabolic abnormalities (e.g. dyslipidemia), increased cardiovascular risk, and drug interactions.
Publication types
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
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Review
MeSH terms
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Cytochrome P-450 CYP3A
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Cytochrome P-450 CYP3A Inhibitors
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Drug Interactions
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Drug Therapy, Combination
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Enzyme Inhibitors / administration & dosage
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Enzyme Inhibitors / pharmacology
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Enzyme Inhibitors / therapeutic use
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HIV Infections / drug therapy*
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HIV Protease Inhibitors / administration & dosage
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HIV Protease Inhibitors / pharmacology
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HIV Protease Inhibitors / therapeutic use*
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Humans
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Ritonavir / administration & dosage
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Ritonavir / pharmacology
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Ritonavir / therapeutic use*
Substances
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Cytochrome P-450 CYP3A Inhibitors
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Enzyme Inhibitors
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HIV Protease Inhibitors
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Cytochrome P-450 CYP3A
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CYP3A4 protein, human
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Ritonavir