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Optimización de la terapia con lopinavir/ritonavir en pacientes infectados por el VIH: aplicación de criterios farmacocinéticos y farmacogenéticos
| Content Provider | Semantic Scholar |
|---|---|
| Author | Aspiroz, Elena López |
| Copyright Year | 2012 |
| Abstract | [ES] Lopinavir/ritonavir (LPV/r) ha demostrado eficacia virologica e inmunologica en el tratamiento antirretroviral (TAR) combinado, tanto en pacientes naive como pretratados. Ademas presenta una alta barrera genetica al desarrollo de resistencias y su perfil de tolerancia es aceptable, aunque son frecuentes alteraciones gastrointestinales y del perfil lipidico. Se revisan diferentes estrategias utilizadas en la optimizacion del TAR con este farmaco en la practica clinica diaria, haciendo especial incidencia en la monitorizacion de concentraciones plasmaticas de LPV/r y la caracterizacion farmacogenetica de las principales isoenzimas responsables de su metabolismo y transporte. En este sentido la correlacion del genotipo con el fenotipo establecida en la monitorizacion de niveles de LPV/r facilitaria la individualizacion posologica de los tratamientos con este farmaco. Asi mismo, se revisa la estrategia de simplificacion del tratamiento a monoterapia lo que permitiria incrementar la seguridad y disminuir los costes.; [EN] Lopinavir/ritonavir (LPV/r) has demonstrated virological and immunological efficacy in the combined antiretroviral treatment (cART), in both naive and experienced patients. Furthermore, LPV/r showed a high barrier to the development of resistance. Although generally well tolerated, adverse gastrointestinal side effects and metabolic disorders are frequent. Different tools that are used to optimize the cART with this drug in the daily clinical practice, emphasizing the therapeutic drug monitoring (TDM) of LPV/r and the genetic analysis of the main enzymes responsible for the metabolism and transport, are reviewed. The relationship between phenotype and genotype, established through TDM, could be useful for the physician to improve the clinical management of the HIV infection, due to the possibility of individualize the dose with this drug. It is also reviewed the monotherapy as a new strategy used in the simplification of the therapy with this drug, which could increase security and reduce costs. |
| File Format | PDF HTM / HTML |
| DOI | 10.14201/gredos.115647 |
| Alternate Webpage(s) | https://gredos.usal.es/jspui/bitstream/10366/115647/1/DFTF_LopezAspinozE_Optimizaci%C3%B3ndelaTerapia.pdf |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
