HIV Unit - Internal Medicine Service, Hospital Universitario La Paz - IdiPAZ, Madrid, Spain.
AIDS Rev. 2014 Apr-Jun;16(2):101-8.
Darunavir/ritonavir monotherapy is an experimental switching strategy for virologically suppressed patients without protease inhibitor resistance to avoid nucleos(t)ide-related toxicities. This therapy maintains virological suppression in most patients, but at slightly lower rates than standard therapy that includes two nucleos(t)ides. Patients experiencing virological failure are generally re-suppressed without emergence of resistance with the resumption of two nucleos(t)ides. Reports of cerebrospinal fluid viral escape has been observed in patients receiving protease inhibitor monotherapy, and concerns exist regarding the capacity of protease inhibitor monotherapy to control HIV infection in the brain and to prevent neurocognitive decline. In the current report we have pooled together available evidence regarding the capacity of darunavir/ritonavir monotherapy to control HIV replication in cerebrospinal fluid and to prevent neurocognitive decline.
达芦那韦/利托那韦单药治疗是一种针对无蛋白酶抑制剂耐药的病毒学抑制患者的实验性转换策略，以避免核苷（酸）相关毒性。这种治疗方法在大多数患者中维持病毒学抑制，但略低于包括两种核苷（酸）的标准治疗。出现病毒学失败的患者通常在恢复使用两种核苷（酸）后重新抑制病毒而不会出现耐药。有报道称，接受蛋白酶抑制剂单药治疗的患者会出现脑脊液病毒逃逸，人们担心蛋白酶抑制剂单药治疗能否控制大脑中的 HIV 感染并预防神经认知下降。在本报告中，我们汇总了现有证据，以评估达芦那韦/利托那韦单药治疗控制脑脊液中 HIV 复制和预防神经认知下降的能力。
