Single-boosted protease inhibitor versus double-boosted protease inhibitors for the salvage therapy in HIV-infected patients

Objective: To compare treatment outcomes between the regimens of single-boosted protease inhibitor (PI) and double-boosted PIs for the salvage therapy in patients who failed nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimens. Methods: A total of 64 patients from 2 cohorts, 40 in twice daily ritonavir-boosted lopinavir (LPV/r) at 400/100 mg plus lamivudine (3TC) and 24 in once daily ritonavir-boosted atazanavir and saquinavir (ATV/SQV/r) at 300/1600/100 mg/d, were studied. Results: At 48 weeks, 30 (75%) patients in LPV/r group and 20 (83%) patients in ATV/SQV/r group achieved HIV-1 RNA at <400 copies/mL (P =.790). In all, 24 (60%) and 16 (67%) achieved HIV-1 RNA at <50 copies/mL (P =.541). Low-level viral rebound (51-400 copies/mL) was found in 6 (15%) in LPV/r group and 4 (17%) in ATV/SQV/r group (P = 1.000). Medians CD4 counts were 336 cells/mm³ and 330 cells/mm³ in the corresponding groups (P = 0.937). Conclusion: No additional benefit is found with double-boosted PIs compared to single-boosted PI in terms of treatment responses in HIV-infected patients failing NNRTI-based regimen.