Efficacy and biological safety of lopinavir/ritonavir based anti-retroviral therapy in HIV-1-infected patients: a meta-analysis of randomized controlled trials

Abstract

Lopinavir/ritonavir (LPV/r) is the first ritonavir-boosted protease-inhibitor used in second-line anti-retroviral treatment (ART) in resource-limited regions. To evaluate the efficacy and safety outcomes of LPV/r in treatment-naïve and -experienced HIV-infected adults and pregnant women, we performed a meta-analysis of randomized controlled trials. Ten cohorts from 8 articles involving 2,584 ART-naïve patients, 5 cohorts from 4 articles involving 1,124 ART-experienced patients, and 8 cohorts from 7 articles involving 2,191 pregnant women were selected for the meta-analyses. For ART-naïve patients, the virologic response rate (72.3%) of LPV/r combined with tenofovir (TDF) plus lamivudine/emtricitabine (3TC/FTC) arms was significantly greater than that of LPV/r plus non-TDF-FTC arms (65.5%, p = 0.047). For ART-experienced patients, the use of LPV/r revealed a 55.7% probability of virologic success. The incidence of abnormal total cholesterol (6.9%) for ART-experienced patients was significantly lower than that for ART-naïve patients (13.1%, p < 0.001). The use of LPV/r in pregnant women revealed a mother-to-child transmission (MTCT) rate of 1.1%, preterm birth rate of 13.2%, and low birth weight rate of 16.2%. Our meta-analysis indicated that LPV/r was an efficacious regimen for ART-naïve patients and was more tolerable for ART-experienced patients. LPV/r also displayed a significant effect in preventing MTCT.

AASLD guidelines for treatment of chronic hepatitis B

“…The use of tenofovir and entecavir was compared in 13 studies with average sample sizes of 62 per treatment group (range, 22‐148). The first RCT of HBV‐infected adults with decompensated cirrhosis showed no significant difference in serum creatinine or creatinine clearance over 48 weeks of tenofovir (n = 45) or entecavir (n = 22) . The second RCT of 200 HBV‐infected adults (100 on tenofovir, 100 on entecavir) showed no significant decline in renal function and no difference in adverse events .…”

“…The evidence profile is summarized in Supporting Table 4. The use of tenofovir and entecavir was compared in 13 studies [76][77][78][79][80][81][82][83][84][85][86][87] with average sample sizes of 62 per treatment group (range, . The first RCT of HBV-infected adults with decompensated cirrhosis showed no significant difference in serum creatinine or creatinine clearance over 48 weeks of tenofovir (n 5 45) or entecavir (n 5 22).…”

Treatment of Middle East Respiratory Syndrome with a combination of lopinavir-ritonavir and interferon-β1b (MIRACLE trial): study protocol for a randomized controlled trial

“…Based on in vitro data, the combination of lopinavir and ritonavir has been considered as a candidate therapy for MERS. Lopinavir and ritonavir are antiretroviral protease inhibitors used in combination for the treatment of human immunodeficiency virus (HIV) infection and have limited side effects [20]. The combination of lopinavir/ritonavir (Kaletra®, Abbott Laboratories, Chicago, IL, USA) has also been used for the treatment of SARS.…”

Impact of lopinavir-ritonavir exposure in HIV-1 infected children and adolescents in Madrid, Spain during 2000-2014

“…The goals of PI/r are to reduce pill burden, side effects, drug interactions and medication cost and to preserve future treatment options [10]. LPV/r is the most-used PI in children today [11–15], and is the preferred antiretroviral (ARV) in first-line-cART for children less than 3 years old [16, 17] and for second-line cART for children when NNRTI-containing regimens were used in first-line cART [18]. LPV/r has been used as part of postexposure prophylaxis in infants [19].…”