The massive and unrestricted use of human immunodeficiency virus 1 (HIV-1) protease inhibitors (PIs) began in Spain in the last 3 months of 1996, although some patients had already been treated with ritonavir through expanded access programs.1 The introduction of PIs, and consequently of highly active antiretroviral therapy, has been associated with a dramatic change in the natural history of HIV-1 infection.2,3 A huge decrease in acquired immunodeficiency syndrome (AIDS)–defining events, the need for hospital admission, and AIDS-associated mortality has been attributed to the introduction of highly active antiretroviral therapy.2,3 Moreover, the quality of life of HIV-infected patients has improved substantially since the widespread use of highly active antiretroviral therapy.1 However, PIs have many important adverse effects and most times their adverse-effect profile is the most important factor limiting the efficacy of PI-based therapeutic regimens.
Guardiola JM, Domingo P, Vazquez G. Switching HIV-1 Protease Inhibitor Therapy: Which? When? And Why? Arch Intern Med. 1999;159(2):194–195. doi:
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