Ritonavir-boosted Protease Inhibitors, Part 1: Strategies for Balancing Efficacy with Effects on Lipids

Ritonavir-boosted protease inhibitor (PI) regimens are beneficial in overcoming the development of resistance, providing durable virologic responses, and potentially reducing pill burden and complexity of treatment. Adverse metabolic effects of boosted PI regimens, particularly on lipid levels, are increasingly common and can result in serious comorbidities in this group of HIV-positive patients by adding to the cardiovascular risk profile. Balancing the efficacy of boosted PI combinations and their toxicity relative to elevations in lipid levels is critical to their success as components of HAART.