10
Selecting a Treatment Regimen
PIs
(cont'd)
LPV/r • Only RTV-
coformulated PI
• No food requirement
• Requires 200 mg per day of
RTV.
• Possible higher risk of MI
associated with cumulative use
of LPV/r.
• PR and QT interval
prolongation have been
reported. Use with caution
in patients at risk of cardiac
conduction abnormalities or in
patients receiving other drugs
with similar effect.
• Possible nephrotoxicity.
• CYP3A4 inhibitors and
substrates: potential for drug
interactions.
Co-Receptor Tropism Assays
Î A co-receptor tropism assay should be performed whenever the use of
a CCR5 co-receptor antagonist is being considered (A-I).
Î Co-receptor tropism testing is also recommended for patients with
HIV who exhibit virologic failure on a CCR5 antagonist (B-III).
Î A phenotypic tropism assay is preferred to determine HIV-1
co-receptor usage (A-I).
Î A genotypic tropism assay should be considered as an alternative test
to predict HIV-1 co-receptor usage (B-II).
HLA-B*5701 Screening
The Panel recommends screening for HLA-B*5701 before starting
patients on an abacavir (ABC)-containing regimen to reduce the risk of
HSR (A-I).
Î HLA-B*5701-positive patients should NOT be prescribed ABC (A-I).
Î The positive status should be recorded as an ABC allergy in the
patient's medical record (A-II).
Î When HLA-B*5701 screening is not readily available, it remains
reasonable to initiate ABC with appropriate clinical counseling and
monitoring for any signs of HSR (C-III).
Table 2. Advantages and Disadvantages of Antiretroviral
Components Recommended as Initial ART (cont'd)
ARV
Class
ARV
Agent(s) Advantages Disadvantages
