5%) employed protease inhibitors: one of the infected patients was being treated with Tenofovir; two with Indinavir; 14 with Atazanavir, 13 with Nelfinavir and 23 with Ritonavir associated with another protease inhibitors (Lopinavir, Atazanavir, Amprenavir
and nelfinavir, develop specific primary mutations first without conferring cross-resistance to other PIs.
More recently, we have shown that HIV itself, rather than the commonly used antiretroviral compounds (stavudine, efavirenz, nevirapine, lopinavir, amprenavir
, nelfinavir and ritonavir), impairs cholesterol efflux .
7-9) Changes in plasma cholesterol and serum triglyceride levels have also been observed with the use of HIV protease inhibitors including: saquinavir, indinavir, ritinavir, lopinavir, amprenavir
Table 1 Common Antiretroviral Drugs (14-16) Classification Generic Name Trade Name Nucleoside reverse Abacavir sulfate Ziagen transcriptase inhibitors Abacavir sulfate + Trizivir (NRTI) lamivudine + zidovudine Didanosine (ddl) Videx, Videx EC Lamivudine (3TC) Epivir Lamiudine + zidovudine Combivir Stavudine (d4T) Zerit Tenofovir disoproxil Viread fumarate Zalcitabine (ddC) Hivid Zidovudine (AZT, ZDV) Retrovir Non-nucleoside reverse Delavirdine mesylate Rescriptor transcriptase inhibitors Efavirenz Sustiva (NNRTI) Nevirapine Viramune Protease inhibitors (PI) Amprenavir
Agenerase Indinavir sulfate Crixivan Lopinavir + ritonavir Kaletra Nelfinavir Viracept Ritonavir Norvir Saquinavir Fortovase Saquinavir mesylate Invirase Fusion inhibitors (FI) Enfuvirtide Fuzeon
Commonly used protease inhibitors in children include ritonavir, nelfinavir, amprenavir
, lopinavir/ritonavir, indinavir, and saquinavir; the first four are available in pediatric formulations.
34,36) There are nine FDA-approved PIs: ritonavir, amprenavir
, fosamprenavir, indinavir, lopinavir (manufactured in combination with ritonavir), nelfinavir, saquinavir, atazanavir, and tipranavir.
, Indinavir, and the widely used combination of Lopinavir and ritonavir are the most frequently prescribed PI medications.
Currently, three groups of drugs are available for the treatment of the HIV infection: the nucleoside inhibitors of reverse transcriptase (zidovudine, didanosine, lamivudine, stavudine, abacavir, zalcitabine), the non-nucleoside inhibitors of reverse transcriptase (nevirapine, delavirdine, efavirenz), and the protease inhibitors (indinavir, nelfinavir, ritonavir, saquinavir, amprenavir
On April 29, 2005 GlaxoSmithKline announced that a drug-interaction trial of Lexiva (fosamprenavir) with Nexium (esomeprazole, a proton-pump inhibitor, often used to reduce stomach acidity for relief of reflux, the unwanted flow of stomach acid into the esophagus), had found no reduction in the in the blood level of amprenavir
Results from prior studies showed that it retains activity against dozens of HIV isolates that are highly resistant to all PIs now available, including amprenavir
, indinavir, lopinavir, nelfinavir, ritonavir, and saquinavir.
High-dose antimicrobial treatment with voriconazole (200 mg twice daily, subsequently reduced to 200 mg daily) was added to the antiretroviral (ritonavir, amprenavir
, trizivir), anticonvulsive, and adjuvant corticosteroid treatment.