9
PIs
(cont'd)
ATV/c
(specific
considerations)
• Coformulated tablet • COBI inhibits active tubular
secretion of Cr and can increase
serum Cr without affecting
renal glomerular function.
• Coadministration with TDF is
NOT recommended in patients
with CrCl <70 mL/min.
• Less long-term clinical
experience than for ATV/r.
• COBI (like RTV) is a potent
CYP3A4 inhibitor, which can
result in significant interactions
with CYP3A substrates.
DRV/c or
DRV/r
• Higher genetic
barrier to resistance
than NNRTIs, EVG,
and RAL
• PI resistance at the
time of treatment
failure uncommon
with PK-enhanced
PIs
• Skin rash.
• Food requirement.
• GI adverse effects.
• CYP3A4 inhibitors and
substrates: potential for drug
interactions.
• Increased CV risk in one
observational cohort study.
DRV/c
(specific
considerations)
• Coformulated tablet • Less long-term clinical
experience than for DRV/r.
• COBI inhibits active tubular
secretion of Cr and can increase
serum Cr without affecting
renal glomerular function.
• Coadministration with TDF is
NOT recommended in patients
with CrCl <70 mL/min.
• Approval primarily based on
PK data comparable to that
for DRV/r rather than on
trials comparing the efficacy of
DRV/c and DRV/r.
• COBI (like RTV) is a potent
CYP3A4 inhibitor, which can
result in significant interactions
with CYP3A substrates.
Table 2. Advantages and Disadvantages of Antiretroviral
Components Recommended as Initial ART (cont'd)
ARV
Class
ARV
Agent(s) Advantages Disadvantages
