, Volume 70, Issue 14, pp 1885–1915


A Review of its Use in the Management of HIV-1 Infection
Adis Drug Evaluation


Lopinavir/ritonavir (Kaletra®) is an orally administered coformulated ritonavir-boosted protease inhibitor (PI) comprising lopinavir and low-dose ritonavir. It is indicated, in combination with other antiretroviral agents, for the treatment of HIV-1 infection in adults, adolescents and children. Lopinavir/ritonavir is available as a tablet, soft-gel capsule and an oral solution for patients with difficulty swallowing.

In well designed, randomized clinical trials, lopinavir/ritonavir, in combination with other antiretroviral therapies (ART), provided durable virological suppression and improved immunological outcomes in both ART-naive and -experienced adult patients with virological failure. Furthermore, lopinavir/ritonavir demonstrated a high barrier to the development of resistance in ART-naive patients. More limited data indicate that it is effective in reducing plasma HIV-1 RNA levels in paediatric patients. Lopinavir/ritonavir has served as a well established benchmark comparator for the noninferiority of other ritonavir-boosted PI regimens. Although generally well tolerated, lopinavir/ritonavir is associated with generally manageable adverse gastrointestinal side effects and hypertriglyceridaemia and hypercholesterolaemia, which may require coadministration of lipid-lowering agents to reduce the risk of coronary heart disease.

Lopinavir/ritonavir, in combination with other ART agents, is a well established and cost-effective treatment for both ART-naive and -experienced patients with HIV-1 infection and, with successful management of adverse events, continues to have a role as an effective component of ART regimens for the control of HIV-1 infection.


  1. 1.
    Dybul M, Fauci AS, Bartlett JG, et al. Guidelines for using antiretroviral agents among HIV-infected adults and adolescents: recommendations of the Panel on Clinical Practices for Treatment of HIV. MMWR Recomm Rep 2002 May 17; 51(RR-7): 1–55PubMedGoogle Scholar
  2. 2.
    DHHS panel on antiretroviral guidelines for adults and adolescents: a working group of the Office of AIDS Research Advisory Council (OARAC). Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents [online]. Available from URL: http://www.aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL.pdf [Accessed 2010 Apr 15]
  3. 3.
    Joint United Nations Programme on HIV/AIDS. 2009 AIDS epidemic update [online]. Available from URL: http://data.unaids.org/pub/Report/2009/JC1700_Epi_Update_2009_en.pdf [Accessed 2010 Apr 12]
  4. 4.
    WHO, UNAIDS, UNICEF. Towards universal access: scaling up priority HIV/AIDS interventions in the health sector: progress report 2008 [online]. Available from URL: http://www.who.int/hiv/pub/towards_universal_access_report_2008.pdf [Accessed 2010 Apr 15]
  5. 5.
    Shet A, Berry L, Mohri H, et al. Tracking the prevalence of transmitted antiretroviral drug-resistant HIV-1: a decade of experience. J Acquir Immune Defic Syndr 2006 Apr 1; 41(4): 439–46PubMedCrossRefGoogle Scholar
  6. 6.
    Gazzard BG, Anderson J, Babiker A, et al. British HIV Association Guidelines for the treatment of HIV-1-infected adults with antiretroviral therapy 2008. HIV Med 2008 Oct; 9(8): 563–608PubMedCrossRefGoogle Scholar
  7. 7.
    Thompson MA, Aberg JA, Cahn P, et al. Antiretroviral treatment of adult HIV infection: 2010 recommendations of the International AIDS Society-USA Panel. JAMA 2010 Jul 21; 304(3): 321–33PubMedCrossRefGoogle Scholar
  8. 8.
    European AIDS Clinical Society (EACS). Guidelines for the clinical management and treatment of HIV infected adults in Europe [online]. Available from URL: http://www.europeanaidsclinicalsociety.org/guidelinespdf/1_Treatment_of_HIV_Infected_Adults.pdf [Accessed 2010 Apr 15]
  9. 9.
    National Guideline Clearinghouse. Antiretroviral therapy [online]. Available from URL: http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=12939&string= [Accessed 2010 Jun 22]
  10. 10.
    Abbott Laboratories. Kaletra® (lopinavir/ritonavir) tablets and oral solution. Prescribing information [online]. Available from URL: http://www.kaletra.com [Accessed 2010 Jun 22]
  11. 11.
    European Medicines Agency. Kaletra® (lopinavir/ritonavir) soft capsules. Summary of product characteristics [online]. Available from URL: http://emc.medicines.org [Accessed 2010 Jun 22]
  12. 12.
    Scott JD. Simplifying the treatment of HIV infection with ritonavir-boosted protease inhibitors in antiretroviral-experienced patients. Am J Health Syst Pharm 2005 Apr; 62: 809–15PubMedGoogle Scholar
  13. 13.
    Cvetkovic RS, Goa KL. Lopinavir/ritonavir: a review of its use in the management of HIV infection. Drugs 2003; 63(8): 769–802PubMedCrossRefGoogle Scholar
  14. 14.
    Oldfield V, Plosker GL. Lopinavir/ritonavir: a review of its use in the management of HIV infection. Drugs 2006; 66(9): 1275–99PubMedCrossRefGoogle Scholar
  15. 15.
    Sham HL, Kempf DJ, Molla A, et al. ABT-378, a highly potent inhibitor of the human immunodeficiency virus protease. Antimicrob Agents Chemother 1998; 42(12): 3218–24PubMedGoogle Scholar
  16. 16.
    Murphy RL, da Silva BA, Hicks CB, et al. Seven-year efficacy of a lopinavir/ritonavir-based regimen in antiretroviral-naive HIV-1-infected patients. HIV Clin Trials 2008; 9(1): 1–10PubMedCrossRefGoogle Scholar
  17. 17.
    Gathe J, da Silva BA, Cohen DE, et al. A once-daily lopinavir/ritonavir-based regimen is noninferior to twice-daily dosing and results in similar safety and tolerability in antiretroviral-naive subjects through 48 weeks. J Acquir Immune Defic Syndr 2009 Apr 15; 50(5): 474–81PubMedCrossRefGoogle Scholar
  18. 18.
    Johnson MA, Gathe Jr JC, Podzamczer D, et al. A once-daily lopinavir/ritonavir-based regimen provides non-inferior antiviral activity compared with a twice-daily regimen. J Acquir Immune Defic Syndr 2006 Oct 1; 43(2): 153–60PubMedCrossRefGoogle Scholar
  19. 19.
    Molina JM, Podsadecki TJ, Johnson MA, et al. A lopinavir/ritonavir-based once-daily regimen results in better compliance and is non-inferior to a twice-daily regimen through 96 weeks. AIDS Res Hum Retroviruses 2007 Dec; 23(12): 1505–14PubMedCrossRefGoogle Scholar
  20. 20.
    Kempf DJ, King MS, Bernstein B, et al. Incidence of resistance in a double-blind study comparing lopinavir/ ritonavir plus stavudine and lamivudine to nelfinavir plus stavudine and lamivudine. J Infect Dis 2004 Jan 1; 189(1): 51–60PubMedCrossRefGoogle Scholar
  21. 21.
    Molina JM, Andrade-Villanueva J, Echevarria J, et al. Once-daily atazanavir/ritonavir versus twice-daily lopinavir/ ritonavir, each in combination with tenofovir and emtricitabine, for management of antiretroviral-naive HIV-1-infected patients: 48 week efficacy and safety results of the CASTLE study. Lancet 2008 Aug 23; 372(9639): 646–55PubMedCrossRefGoogle Scholar
  22. 22.
    Ortiz R, Dejesus E, Khanlou H, et al. Efficacy and safety of once-daily darunavir/ritonavir versus lopinavir/ritonavir in treatment-naive HIV-1-infected patients at week 48. AIDS 2008 Jul 31; 22(12): 1389–97PubMedCrossRefGoogle Scholar
  23. 23.
    Mills AM, Nelson M, Jayaweera D, et al. Once-daily darunavir/ritonavir vs. lopinavir/ritonavir in treatment-naive, HIV-1-infected patients: 96-week analysis. AIDS 2009 Aug 24; 23(13): 1679–88PubMedCrossRefGoogle Scholar
  24. 24.
    Eron Jr J, Yeni P, Gathe Jr J. The KLEAN study of fosamprenavir-ritonavir versus lopinavir-ritonavir, each in combination with abacavir-lamivudine, for initial treatment of HIV infection over 48 weeks: a randomised non-inferiority trial. Lancet 2006; 368(9534): 476–82PubMedCrossRefGoogle Scholar
  25. 25.
    Pulido F, Estrada V, Baril JG, et al. Long-term efficacy and safety of fosamprenavir plus ritonavir versus lopinavir/ ritonavir in combination with abacavir/lamivudine over 144 weeks. HIV Clin Trials 2009; 10(2): 76–87PubMedCrossRefGoogle Scholar
  26. 26.
    Riddler SA, Haubrich R, DiRienzo AG, et al. Class-sparing regimens for initial treatment of HIV-1 infection. N Engl J Med 2008 May 15; 358(20): 2095–106PubMedCrossRefGoogle Scholar
  27. 27.
    Saez-Llorens X, Violari A, Deetz CO, et al. Forty-eight-week evaluation of lopinavir/ritonavir, a new protease inhibitor, in human immunodeficiency virus-infected children. Pediatr Infect Dis J 2003 Mar; 22: 216–23PubMedGoogle Scholar
  28. 28.
    Kempf DJ, Isaacson JD, King MS, et al. Identification of genotypic changes in human immunodeficiency virus protease that correlate with reduced susceptibility to the protease inhibitor lopinavir among viral isolates from protease inhibitor-experienced patients. J Virol 2001 Aug; 75(16): 7462–9PubMedCrossRefGoogle Scholar
  29. 29.
    Mo H, King MS, King K, et al. Selection of resistance in protease inhibitor-experienced, human immunodeficiency virus type 1-infected subjects failing lopinavir- and ritonavir-based therapy: mutation patterns and baseline correlates. J Virol 2005 Mar; 79(6): 3329–38PubMedCrossRefGoogle Scholar
  30. 30.
    Garriga C, Perez-Elias MJ, Delgado R, et al. Mutational patterns and correlated amino acid substitutions in the HIV-1 protease after virological failure to nelfinavir- and lopinavir/ritonavir-based treatments. J Med Virol 2007 Nov;79(11): 1617–28PubMedCrossRefGoogle Scholar
  31. 31.
    Kempf DJ, Isaacson JD, King MS, et al. Analysis of the virologic response with respect to baseline viral phenotype and genotype in protease inhibitor-experienced HIV-1-infected patients receiving lopinavir/ritonavir. Antiviral Ther 2002 Sep; 7(3): 165–74Google Scholar
  32. 32.
    King M, Rode R, Cohen-Codar I, et al. Predictive genotypic algorithm for virologic response to lopinavir-ritonavir in protease inhibitor-experienced patients. Antimicrob Agents Chemother 2007; 51(9): 3067–74PubMedCrossRefGoogle Scholar
  33. 33.
    Loutfy MR, Raboud JM, Walmsley SL, et al. Predictive value of HIV-1 protease genotype and virtual phenotype on the virological response to lopinavir/ritonavir-containing salvage regimens. Antivir Ther 2004 Aug; 9(4): 595–602PubMedGoogle Scholar
  34. 34.
    Grant P, Wong E, Rode R, et al. Virologic response to lopinavir-ritonavir-based antiretroviral regimens in a multicenter international clinical cohort: Comparison of genotypic interpretation scores. Antimicrob Agents Chemother 2008; 52(11): 4050–6PubMedCrossRefGoogle Scholar
  35. 35.
    Di Giambenedetto S, Barcarelli A, Pinnetti C, et al. Genotypic resistance to lopinavir and fosamprenavir with or without ritonavir of clinical isolates from patients failing protease inhibitors-containing HAART regimens: prevalence and predictors. Scand J Infect Dis 2007 Oct; 39 (No. 9): 813–8PubMedCrossRefGoogle Scholar
  36. 36.
    Jimenez JL, Resino S, Martinez-Colom A, et al. Mutations at codons 54 and 82 of HIV protease predict virological response of HIV-infected children on salvage lopinavir/ritonavir therapy. J Antimicrob Chemother 2005 Dec; 56 (No. 6): 1081–6CrossRefGoogle Scholar
  37. 37.
    Johnson M, Grinsztejn B, Rodriguez C, et al. Atazanavir plus ritonavir or saquinavir, and lopinavir/ritonavir in patients experiencing multiple virological failures. AIDS 2005 Apr 29; 19(7): 685–94PubMedCrossRefGoogle Scholar
  38. 38.
    Johnson M, Grinsztejn B, Rodriguez C, et al. 96-Week comparison of once-daily atazanavir/ritonavir and twice-daily lopinavir/ritonavir in patients with multiple virologic failures. AIDS 2006; 20(5): 711–8PubMedCrossRefGoogle Scholar
  39. 39.
    Madruga JV, Berger D, McMurchie M, et al. Efficacy and safety of darunavir-ritonavir compared with that of lopinavir-ritonavir at 48 weeks in treatment-experienced, HIV-infected patients in TITAN: a randomised controlled phase III trial. Lancet 2007; 370(9581): 49–58PubMedCrossRefGoogle Scholar
  40. 40.
    De Meyer S, Hill A, Picchio G, et al. Influence of baseline protease inhibitor resistance on the efficacy of darunavir/ritonavir or lopinavir/ritonavir in the TITAN trial [letter]. J Acquir Immune Defic Syndr 2008 Dec 15; 49(5): 563–4PubMedCrossRefGoogle Scholar
  41. 41.
    Fischl MA, Collier AC, Mukherjee AL, et al. Randomized open-label trial of two simplified, class-sparing regimens following a first suppressive three or four-drug regimen. AIDS 2007 Jan 30; 21(3): 325–33PubMedCrossRefGoogle Scholar
  42. 42.
    Parkin NT, Chappey C, Petropoulos CJ. Improving lopinavir genotype algorithm through phenotype correlations: novel mutation patterns and amprenavir cross-resistance. AIDS 2003; 17: 955–61PubMedCrossRefGoogle Scholar
  43. 43.
    Eron J, Feinberg J, Kessler HA, et al. Once-daily versus twice-daily lopinavir/ritonavir in antiretroviral-naive HIV-positive patients: a 48-week randomized clinical trial. J Infect Dis 2004 Jan 15; 189(2): 265–72PubMedCrossRefGoogle Scholar
  44. 44.
    Crommentuyn KML, Mulder JW, Mairuhu ATA, et al. The plasma and intracellular steady-state pharmacokinetics of lopinavir/ritonavir in HIV-1-infected patients. Antiviral Ther 2004 Oct; 9(5): 779–85Google Scholar
  45. 45.
    Klein CE, Chiu YL, Awni W, et al. The tablet formulation of lopinavir/ritonavir provides similar bioavailability to the soft-gelatin capsule formulation with less pharmacokinetic variability and diminished food effect. J Acquir Immune Defic Syndr 2007 Apr 1; 44(4): 401–10PubMedCrossRefGoogle Scholar
  46. 46.
    Hull MW, Harris M, Lima V, et al. Lopinavir/ritonavir pharmacokinetics in a substitution of high-dose soft-gelatin capsule to tablet formulation. J Clin Pharmacol 2009 Feb; 49(2): 155–61PubMedCrossRefGoogle Scholar
  47. 47.
    Murphy RL, Brun S, Hicks C, et al. ABT-378/ritonavir plus stavudine and lamivudine for the treatment of antiretroviral-naive adults with HIV-1 infection: 48-week results. AIDS 2001 Jan 5; 15(1): F1–9PubMedCrossRefGoogle Scholar
  48. 48.
    Stek AM, Mirochnick M, Capparelli E, et al. Reduced lopinavir exposure during pregnancy. AIDS 2006 Oct 3; 20(15): 1931–9PubMedCrossRefGoogle Scholar
  49. 49.
    Peng JZ, Pulido F, Kemmis Causemaker SJ, et al. Pharmacokinetics of lopinavir/ritonavir in HIV/Hepatitis C virus — coinfected subjects with hepatic impairment. J Clin Pharmacol 2006 Mar; 46 (No. 3): 265–74PubMedCrossRefGoogle Scholar
  50. 50.
    Kumar GN, Rodrigues AD, Buko AM, et al. Cytochrome P450-mediated metabolism of the HIV-1 protease inhibitor ritonavir (ABT-538) in human liver microsomes. J Pharmacol Exp Ther 1996; 277: 423–31PubMedGoogle Scholar
  51. 51.
    Kumar GN, Dykstra J, Roberts EM, et al. Potent inhibition of the cytochrome P-450 3A-mediated human liver microsomal metabolism of a novel HIV protease inhibitor by ritonavir: a positive drug-drug interaction. Drug Metab Dispos 1999; 27(8): 902–8PubMedGoogle Scholar
  52. 52.
    Sankatsing SU, Droste J, Burger D, et al. Limited penetration of lopinavir into seminal plasma of HIV-1-infected men [letter]. AIDS 2002 Aug 16; 16(12): 1698–700PubMedCrossRefGoogle Scholar
  53. 53.
    Vergara TRC, Estrela RCE, Suarez-Kurtz G, et al. Limited penetration of lopinavir and ritonavir in the genital tract of men infected with HIV-1 in Brazil. Ther Drug Monit2006 Apr; 28 (No. 2): 175–9PubMedCrossRefGoogle Scholar
  54. 54.
    Dumond JB, Yeh RF, Patterson KB, et al. Antiretroviral drug exposure in the female genital tract: implications for oral pre- and post-exposure prophylaxis. AIDS 2007 Sep 12; 21(14): 1899–907PubMedCrossRefGoogle Scholar
  55. 55.
    Corbett A, Martinson F, Rezk N, et al. Lopinavir/ritonavir concentrations in breast milk and breast-feeding infants [abstract no. 947]. 16th Conference on Retroviruses and Opportunistic Infections; 2009 Feb 8–11; MontrealGoogle Scholar
  56. 56.
    Capparelli EV, Holland D, Okamoto C, et al. Lopinavir concentrations in cerebrospinal fluid exceed the 50% inhibitory concentration for HIV. AIDS 2005 Jun 10; 19(9): 949–52PubMedCrossRefGoogle Scholar
  57. 57.
    Kumar GN, Jayanti V, Lee RD, et al. In vitro metabolism of the HIV-1 protease inhibitor ABT-378: species comparison and metabolite identification. Drug Metab Dispos 1999; 27(1): 86–91PubMedGoogle Scholar
  58. 58.
    Kumar GN, Jayanti VK, Johnson MK, et al. Metabolism and disposition of the HIV-1 protease inhibitor lopinavir (ABT-378) given in combination with ritonavir in rats, dogs, and humans. Pharm Res 2004 Sep; 21(9): 1622–30PubMedCrossRefGoogle Scholar
  59. 59.
    Walmsley S, Avihingsanon A, Slim J, et al. Gemini: a non-inferiority study of saquinavir/ritonavir versus lopinavir/ritonavir as initial HIV-1 therapy in adults. J Acquir Immune Defic Syndr 2009 Apr 1; 50(4): 367–74PubMedCrossRefGoogle Scholar
  60. 60.
    Hicks C, King MS, Gulick RA, et al. Long-term safety and durable antiretroviral activity of lopinavir/ritonavir in treatment-naive patients: 4 year follow-up study. AIDS 2004 Mar 26; 18(5): 775–9PubMedCrossRefGoogle Scholar
  61. 61.
    Molina JM, Andrade-Villanueva J, Echevarria J, et al. Once-daily atazanavir/ritonavir compared with twice-daily lopinavir/ritonavir, each in combination with tenofovir and emtricitabine, for management of antiretroviral-naive HIV-1-infected patients: 96-week efficacy and safety results of the CASTLE study. J Acquir Immune Defic Syndr 2010 Mar1; 53(3): 323–32PubMedCrossRefGoogle Scholar
  62. 62.
    Pollard RB, Thompson M, Hicks M, et al. Phase 3 comparison of lopinavir/ritonavir vs investigator-selected protease inhibitors in single PI-experienced, NNRTI-naive patients: 48-week results of study M98-888 [abstract no. PI.3.2 plus poster]. 7th International Congress on Drug Therapy in HIV Infection; 2004 Nov 14–18; GlasgowGoogle Scholar
  63. 63.
    Cohen C, Nieto-Cisneros L, Zala C, et al. Comparison of atazanavir with lopinavir/ritonavir in patients with prior protease inhibitor failure: a randomized multinational trial. Curr Med Res Opin 2005 Oct; 21(10): 1683–92PubMedCrossRefGoogle Scholar
  64. 64.
    Eron JJ, Young B, Cooper DA, et al. Switch to a raltegravir-based regimen versus continuation of a lopinavir-ritonavir-based regimen in stable HIV-infected patients with suppressed viraemia (SWITCHMRK 1 and 2): two multicentre, double-blind, randomised controlled trials. Lancet 2010 Jan 30; 375(9712): 396–407PubMedCrossRefGoogle Scholar
  65. 65.
    Dragsted UB, Gerstoft J, Youle M, et al. A randomized trial to evaluate lopinavir/ritonavir versus saquinavir/ritonavir in HIV-1-infected patients: the MaxCmin2 trial. Antiviral Ther 2005; 10(6): 735–43Google Scholar
  66. 66.
    Zajdenverg R, Podsadecki T, Badal-Faesen S, et al. Similar safety and efficacy of once- and twice-daily lopinavir/ ritonavir tablets in treatment-experienced HIV-1-infected subjects at 48 weeks. J Aquir Immune Defic Syndr 2010; 54(2): 143–51Google Scholar
  67. 67.
    Walmsley S, Bernstein B, King M, et al. Lopinavir-ritonavir versus nelfinavir for the initial treatment of HIV infection. N Engl J Med 2002 Jun 27; 346(26): 2039–46PubMedCrossRefGoogle Scholar
  68. 68.
    Ghosn J, Flandre P, Cohen-Codar I, et al. Long-term (96-week) follow-up of antiretroviral-naive HIV-infected patients treated with first-line lopinavir/ritonavir monotherapy in the MONARK trial. HIV Med 2010; 11(2): 137–42PubMedCrossRefGoogle Scholar
  69. 69.
    Cameron DW, Da Silva BA, Arribas JR, et al. A 96-week comparison of lopinavir-ritonavir combination therapy followed by lopinavir-ritonavir monotherapy versus efavirenz combination therapy. J Infect Dis 2008; 198(2): 234–40PubMedCrossRefGoogle Scholar
  70. 70.
    Banhegi D, Katlama C, Da Cunha C, et al. Phase III TITAN week 96 final analysis: efficacy/safety of darunavir/r (DRV/r) vs. lopinavir/r (LPV/r) in LPV-naive treatment-experienced patients [abstract no. 22]. 9th International Congress on Drug Therapy in HIV Infection; 2008 Nov 9–13; GlasgowGoogle Scholar
  71. 71.
    Podzamczer D, King MS, Klein CE, et al. High-dose lopinavir/ritonavir in highly treatment-experienced HIV-1 patients: efficacy, safety, and predictors of response. HIV Clin Trials 2007; 8(4): 193–204PubMedCrossRefGoogle Scholar
  72. 72.
    Pulido F, Arribas JR, Delgado R, et al. Lopinavir-ritonavir monotherapy versus lopinavir-ritonavir and two nucleosides for maintenance therapy of HIV. AIDS 2008 Jan 11; 22(2): F1–9PubMedCrossRefGoogle Scholar
  73. 73.
    Arribas J, Delgado R, Arranz A, et al. Lopinavir-ritonavir monotherapy versus lopinavir-ritonavir and 2 nucleosides for maintenance therapy of HIV: 96-Week analysis. J Acquir Immune Defic Syndr 2009; 51(2): 147–52PubMedCrossRefGoogle Scholar
  74. 74.
    Bongiovanni M, Bini T, Capetti A, et al. Long-term antiretroviral efficacy and safety of lopinavir/ritonavir in HAART-experienced subjects: 4 year follow-up study. AIDS 2005; 19(16): 1934–6PubMedCrossRefGoogle Scholar
  75. 75.
    Kosalaraksa P, Bunupuradah T, Engchanil C, et al. Double boosted protease inhibitors, saquinavir, and lopinavir/ritonavir, in nucleoside pretreated children at 48 weeks. Pediatr Infect Dis J 2008 Jul; 27(7): 623–8PubMedCrossRefGoogle Scholar
  76. 76.
    Bunupuradah T, van der Lugt J, Kosalaraksa P, et al. Safety and efficacy of a double-boosted protease inhibitor combination, saquinavir and lopinavir/ritonavir, in pretreated children at 96 weeks. Antivir Ther 2009; 14(2): 241–8PubMedGoogle Scholar
  77. 77.
    Kline MW, Rugina S, Ilie M, et al. Long-term follow-up of 414 HIV-infected Romanian children and adolescents receiving lopinavir/ritonavir-containing highly active antiretroviral therapy. Pediatrics 2007 May; 119(5): e1 116–20CrossRefGoogle Scholar
  78. 78.
    WHO. Antiretroviral therapy of HIV infection in infants and children in resource-limited settings, towards iniversal access: recommendations for a public health approach [online]. Available from URL: http://www.who.int/hiv/pub/guidelines/WHOpaediatric.pdf [Accessed 2010Mar 23]
  79. 79.
    Ministry of Public Health, Thailand. National guidelines for the clinical management of HIV infection in children and adults. Bangkok: Ministry of Public Health, 2004Google Scholar
  80. 80.
    de la Fuente JS, Granja V, Escobar I, et al. Study of the gastrointestinal tolerance of a new tablet formulation of the lopinavir/ritonavir antiretroviral in HIV-infected patients. J Acquir Immune Defic Syndr 2009 Mar 1; 50(3): 294–8CrossRefGoogle Scholar
  81. 81.
    Simpson KN, Jones WJ, Rajagopalan R, et al. Cost effectiveness of lopinavir/ritonavir compared with atazanavir plus ritonavir in antiretroviral-experienced patients in the US. Clin Drug Investig 2007; 27(7): 443–52PubMedCrossRefGoogle Scholar
  82. 82.
    Simpson KN, Rajagopalan R, Dietz B. Cost-effectiveness analysis of lopinavir/ritonavir and atazanavir+ritonavir regimens in the CASTLE study. Adv Ther 2009 Feb; 26(2): 185–93PubMedCrossRefGoogle Scholar
  83. 83.
    Simpson KN, Jones WJ, Rajagopalan R, et al. Cost effectiveness of lopinavir/ritonavir tablets compared with atazanavir plus ritonavir in antiretroviral-experienced patients in the UK, France, Italy and Spain. Clin Drug Investig 2007; 27(12): 807–17PubMedCrossRefGoogle Scholar
  84. 84.
    Fletcher CV. Translating efficacy into effectiveness in anti-retroviral therapy: beyond the pill count. Drugs 2007; 67(14): 1969–79PubMedCrossRefGoogle Scholar
  85. 85.
    WHO. Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach [online]. Available from URL: http://www.who.int/hiv/pub/guidelines/artadultguidelines.pdf [Accessed 2010 Apr 30]
  86. 86.
    Cooper CL, van Heeswijk RP, Gallicano K, et al. A review of low-dose ritonavir in protease inhibitor combination therapy. Clin Infect Dis 2003 Jun 15; 36(12): 1585–92PubMedCrossRefGoogle Scholar
  87. 87.
    Swainston Harrison T, Scott LJ. Atazanavir: a review of its use in the management of HIV infection. Drugs 2005; 65(16): 2309–36PubMedCrossRefGoogle Scholar
  88. 88.
    Croom KF, Dhillon S, Keam SJ. Atazanavir: a review of its use in the management of HIV-1 infection. Drugs 2009; 69(8): 1107–40PubMedCrossRefGoogle Scholar
  89. 89.
    Friis-Moller N, Weber R, Reiss P, et al. Cardiovascular disease risk factors in HIV patients — association with antiretroviral therapy. Results from the DAD study. AIDS 2003 May 23; 17(8): 1179–93PubMedCrossRefGoogle Scholar
  90. 90.
    Working Group on Antiretroviral Therapy and Medical Management of HIV-Infected Children. Guidelines for the use of antiretroviral agents in pediatric HIV infection [online]. Available from URL: http://aidsinfo.nih.gov/contentfiles/PediatricGuidelines.pdf [Accessed 2010 Apr 29]
  91. 91.
    Martinez B, Riordan F. Novel strategies in the use of lopinavir/ritonavir for the treatment of HIV infection in children. HIV/AIDS Res Pall Care 2010; 2: 59–67Google Scholar

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© Adis Data Information BV 2010

Authors and Affiliations

  1. 1.Adis, a Wolters Kluwer BusinessMairangi Bay, North Shore, AucklandNew Zealand

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