Important note: Information in this article was accurate in September 2002. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; September 23, 2002
Michael Greer, Senior Medical Writer
"Lopinavir is a newly developed inhibitor of human immunodeficiency virus (HIV) protease that, when formulated with ritonavir, yields mean trough plasma lopinavir concentrations that are at least 75 times as high as that needed to inhibit replication of wild-type HIV by 50 percent," explained Sharon Walmsley and colleagues working at Toronto General Hospital and other institutions in Canda, the United States, Great Britain, Spain, and South Africa.
Antiretroviral regimens based on lopinavir and ritonavir are safer and more effective than nelfinavir-based regimens, Walmsley and coauthors found.
The researchers compared the performance of these protease inhibitors in a group of 653 antiretroviral-naive HIV patients. In addition to stavudine and lamivudine, study participants received either 400 mg of lopinavir with 100 mg of ritonavir twice a day or 750 mg nelfinavir three times a day, they said.
More than two-thirds of patients treated with lopinavir and ritonavir saw their viral load drop to undectable levels, compared with about 50% of nelfinavir-treated patients, study data showed. Patients in the lopanivir-ritonavir group were also significantly less likely to develop viral drug resistance than their nelfinavir-treated counterparts.
Drug toxicity was mild for both regimens (Lopinavir-ritonavir versus nelfinavir for the initial treatment of HIV infection. N Engl J Med 2002 Jun 27;346(26):2039-46.
"For the initial treatment of HIV-infected adults, a combination regimen that includes lopinavir-ritonavir is well tolerated and has antiviral activity superior to that of a nelfinavir-containing regimen," Walmsley and colleagues concluded.
The corresponding author for this report is Sharon Walmsley, Toronto General Hospital, Division of Infectious Diseases, Room EN G-219, 200 Elizabeth St., Toronto, ON M5G 2C4, Canada. E-mail: .
A search at www.NewsRx.net using the search term "AIDS and HIV therapy" yielded 1193 articles in 29 specialized reports.
Key points reported in this study include:
This article was prepared by AIDS Weekly editors from staff and other reports.
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