Abstract
BackgroundProtease inhibitor monotherapy is associated with more frequent episodes of viral rebounds above 50 copies/mL than triple therapy. Objective: To evaluate if, compared to triple-drug therapy, protease inhibitor monotherapy is associated with increased levels of inflammatory/procoagulant markers and more frequent plasma residual viremia detection.MethodsIn this cross-sectional study, we included patients treated for ≥ 1 year with darunavir/ritonavir or lopinavir/ritonavir as monotherapy (n = 72) or with two nucleos(t)ides (n = 74). All samples were tested for CRP, IL-6, fibrinogen and D-dimer. Residual viremia was determined using an ultrasensitive qualitative nested-PCR of the HIV pol gene with a limit of detection of 1 copy of HIV-RNA.ResultsWe found no differences in levels of inflammatory/procoagulant markers or in the proportion of patients with plasma residual viremia detection by treatment group.ConclusionThe long-term treatment with protease inhibitor monotherapy in the setting of routine clinical practice is not associated with a higher prevalence of plasma residual viremia or more elevated inflammatory/procoagulant markers levels than triple drug therapy.
Highlights
Protease inhibitor monotherapy is associated with more frequent episodes of viral rebounds above 50 copies/mL than triple therapy
It has been suggested that episodes of low level viremia might lead to higher levels of inflammation and procoagulant markers such as interleukin-6 (IL-6), Creactive protein (CRP) and D-dimer
We have not found differences in IL-6 levels ≥3 pg/mL and CRP levels ≥ 5 mg which have been associated with higher rates of progression to AIDS or death and an increased cardiovascular risk [6,7]
Summary
Protease inhibitor monotherapy is associated with more frequent episodes of viral rebounds above 50 copies/mL than triple therapy. Objective: To evaluate if, compared to triple-drug therapy, protease inhibitor monotherapy is associated with increased levels of inflammatory/procoagulant markers and more frequent plasma residual viremia detection. Protease inhibitor (PI) monotherapy (MT) has been effective in maintaining long-term viral suppression in the majority of patients [1]. MT is associated with more frequent episodes of viral rebounds above 50 copies/mL than triple therapy (TT). It has been suggested that episodes of low level viremia might lead to higher levels of inflammation and procoagulant markers such as interleukin-6 (IL-6), Creactive protein (CRP) and D-dimer. In the MONET clinical trial [2], virologically suppressed patients were randomized to darunavir/ritonavir as MT or
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