Meta-análisis sobre la eficacia de la estrategia de monoterapia con inhibidores de la proteasa potenciados en pacientes VIH+

Abstract

The results of the combined effectiveness analysis in the meta-analysis found no significant differences between the conventional strategy and monotherapy. This strategy is considered recommended (level A evidence) in patients with no history of previous failure of protease inhibitor, with undetectable plasma viral load and signs or symptoms of nucleoside/nucleotide toxicity.

Observational study to evaluate discontinuation of monotherapy with cobicistat-boosted darunavir in patients with human immunodeficiency virus

“…That said, at the end of the study 1 to 3 rd of the patients continued ART in monotherapy, which shows that it is still a viable alternative in some selected however, the reason for this is not the improvement in adherence on simplifying the taking of antiretrovirals, but rather, above all, the avoidance of continued exposure to multiple active ingredients and the contraindication of NRTI, as well as the reluctance of the patients to change treatment. [15] This would explain the reason for prescribing double combination therapy to many of our patients with discontinued monotherapy, despite the change to triple therapy being recommended in patients with poor adherence or VF. [1] In most patients the CD4 lymphocyte count following the start of monotherapy increased, although in the last analysis, 21% of the patients with monotherapy had detectable VL.…”

Identificación de pacientes en tratamiento antirretroviral candidatos a monoterapia con inhibidores de la proteasa

“…Un metaanálisis recientemente publicado en su revista concluye que la simplificación a monoterapia con inhibidores de la proteasa (IP), lopinavir potenciado con ritonavir (LPV/r), reintroduciendo en caso de rebrote viral inhibidores de la transcriptasa inversa, ha demostrado una eficacia comparable al tratamiento antirretroviral (TARV) combinado en ensayos clínicos 1 . Además se han utilizado otras estrategias en monoterapia con IP con buenos resultados, como es el caso del darunavir potenciado con ritonavir (DRV/r), no obstante, más ensayos con seguimientos a largo plazo son necesarios para confirmar dicha eficacia 2 .…”