{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:44:30Z","timestamp":1790232270493,"version":"4.1.0"},"reference-count":29,"publisher":"American Society for Microbiology","issue":"8","license":[{"start":{"date-parts":[[2013,8,1]],"date-time":"2013-08-01T00:00:00Z","timestamp":1375315200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>There is significant intra- and intersubject variability in lopinavir (LPV) plasma concentrations after standard dosing; thus, this prospective study was conducted to determine whether low plasma LPV concentrations could be associated with virological outcome throughout lopinavir-ritonavir maintenance monotherapy (mtLPVr) in the clinical practice setting. If this hypothesis would be confirmed, LPV drug monitoring could improve the efficacy of mtLPVr regimens. Patients with previous virological failure (VF) on protease inhibitor-based regimens were also included if the genotypic resistance tests showed no major resistance mutation associated with reduced susceptibility to lopinavir-ritonavir. VF was defined as 2 consecutive determinations of HIV RNA levels of &gt;200 copies\/ml. Efficacy was analyzed by per-protocol analysis. Plasma LPV trough concentrations were measured by high-performance liquid chromatography using a UV detector. A total of 127 patients were included (22% with previous failure on protease inhibitors). After 96 weeks, the efficacy rate was 82.3% (95% confidence interval [CI<jats:sub>95<\/jats:sub>], 75.3 to 89.3%). Virological efficacy was independent of LPV plasma concentrations even when LPVr was given once daily. An adherence of &lt;90% (HR, 4.4 [CI<jats:sub>95<\/jats:sub>, 1.78 to 10.8;<jats:italic>P<\/jats:italic>= 0.001]) and the presence of blips in the preceding 12 months (HR, 3.06 [CI<jats:sub>95<\/jats:sub>, 1.17 to 8.01;<jats:italic>P<\/jats:italic>= 0.022]) were the only variables independently associated with time to VF. These findings suggest that the LPV concentrations achieved with the standard doses of LPVr are sufficient to maintain virological control during monotherapy and that measurement of LPV concentrations is not useful for predicting virological outcome. Tight control of viral replication in the previous months and strict adherence throughout the mtLPVr regimen could improve the virological efficacy of this maintenance regimen.<\/jats:p>","DOI":"10.1128\/aac.00315-13","type":"journal-article","created":{"date-parts":[[2013,5,29]],"date-time":"2013-05-29T04:58:59Z","timestamp":1369803539000},"page":"3746-3751","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":21,"title":["Lopinavir Plasma Concentrations and Virological Outcome with Lopinavir-Ritonavir Monotherapy in HIV-1-Infected Patients"],"prefix":"10.1128","volume":"57","author":[{"given":"Luis F.","family":"Lopez-Cortes","sequence":"first","affiliation":[{"name":"Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio\/CSIC\/Universidad de Sevilla, Seville, Spain"},{"name":"Enfermedades Infecciosas, Microbiolog\u00eda y Medicina Preventiva, Hospital Universitario Virgen del Rocio, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Ruiz-Valderas","sequence":"additional","affiliation":[{"name":"Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio\/CSIC\/Universidad de Sevilla, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"S\u00e1nchez-Rivas","sequence":"additional","affiliation":[{"name":"Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio\/CSIC\/Universidad de Sevilla, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amparo","family":"Lluch","sequence":"additional","affiliation":[{"name":"Farmacia Hospitalaria, Hospital Universitario Virgen del Rocio, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Gutierrez-Valencia","sequence":"additional","affiliation":[{"name":"Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio\/CSIC\/Universidad de Sevilla, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almudena","family":"Torres-Cornejo","sequence":"additional","affiliation":[{"name":"Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio\/CSIC\/Universidad de Sevilla, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar J.","family":"BenMarzouk-Hidalgo","sequence":"additional","affiliation":[{"name":"Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio\/CSIC\/Universidad de Sevilla, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pompeyo","family":"Viciana","sequence":"additional","affiliation":[{"name":"Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio\/CSIC\/Universidad de Sevilla, Seville, Spain"},{"name":"Enfermedades Infecciosas, Microbiolog\u00eda y Medicina Preventiva, Hospital Universitario Virgen del Rocio, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.7961"},{"key":"e_1_3_2_3_2","unstructured":"Panel on Antiretroviral Guidelines for Adults and Adolescents. 2012. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services Washington DC. http:\/\/www.aidsinfo.nih.gov\/contentfiles\/lvguidelines\/."},{"key":"e_1_3_2_4_2","unstructured":"European AIDS Clinical Society. 2012. European guidelines for treatment of HIV infected adults in Europe version 6.1. European AIDS Clinical Society Paris France. http:\/\/www.europeanaidsclinicalsociety.org\/images\/stories\/EACS-Pdf\/EACSGuidelines-v6.1-English-Nov2012.pdf."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eimc.2012.03.007"},{"key":"e_1_3_2_6_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1468-1293.2012.01029.x","article-title":"British HIV Association guidelines for the treatment of HIV-1-positive adults with antiretroviral therapy","volume":"13","author":"Williams I","year":"2012","unstructured":"WilliamsI ChurchillD AndersonJ BoffitoM BowerM CairnsG CwynarskiK EdwardsS FidlerS FisherM FreedmanA GerettiAM GilleeceY HorneR JohnsonM KhooS LeenC MarshallN NelsonM OrkinC PatonN PhillipsA PostF PozniakA SabinC TrevelionR UstianowskiA WalshJ WatersL WilkinsE WinstonA YouleM. 2012. British HIV Association guidelines for the treatment of HIV-1-positive adults with antiretroviral therapy. HIV Med. 13(Suppl 2):1\u201385.","journal-title":"HIV Med"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.qai.0000180077.59159.f4"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e3282f4243b"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkm198"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1086\/589622"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1310\/hct1006-368"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkq327"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32833db9a1"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0023726"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200305020-00029"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1476-5381.2010.00759.x"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.46.9.2926-2932.2002"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200406180-00009"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.49.5.1720-1726.2005"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1293.2006.00354.x"},{"key":"e_1_3_2_21_2","first-page":"266","article-title":"Antiretroviral drug resistance testing in adult HIV-1 infection: 2008 recommendations of an International AIDS Society-USA panel","volume":"16","author":"Hirsch MS","year":"2008","unstructured":"HirschMS G\u00fcnthardHF SchapiroJM Brun-V\u00e9zinetF ClotetB HammerSM JohnsonVA KuritzkesDR MellorsJW PillayD YeniPG JacobsenDM RichmanDD, International AIDS Society-USA. 2008. Antiretroviral drug resistance testing in adult HIV-1 infection: 2008 recommendations of an International AIDS Society-USA panel. Top. HIV Med. 16:266\u2013285.","journal-title":"Top. HIV Med"},{"key":"e_1_3_2_22_2","unstructured":"Abbott Laboratories. 2013. Kaletra. Full prescribing information. Abbott Laboratories North Chicago IL. http:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2013\/021251s045 021906s038lbl.pdf."},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2010.01.008"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-12-100"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007691-200306000-00023"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.1.350-359.2003"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1310\/hct0904-238"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1089\/aid.2008.0217"},{"key":"e_1_3_2_29_2","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1177\/135965350400900520","article-title":"The plasma and intracellular steady-state pharmacokinetics of lopinavir\/ritonavir in HIV-1-infected patients","volume":"9","author":"Crommentuyn KM","year":"2004","unstructured":"CrommentuynKM MulderJW MairuhuAT van GorpEC MeenhorstPL HuitemaAD BeijnenJH. 2004. The plasma and intracellular steady-state pharmacokinetics of lopinavir\/ritonavir in HIV-1-infected patients. Antivir. Ther. 9:779\u2013785.","journal-title":"Antivir. Ther"},{"key":"e_1_3_2_30_2","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1177\/135965350901400210","article-title":"Risk factors for loss of virological suppression in patients receiving lopinavir\/ritonavir monotherapy for maintenance of HIV suppression","volume":"14","author":"Pulido F","year":"2009","unstructured":"PulidoF P\u00e9rez-ValeroI DelgadoR ArranzA PasquauJ PortillaJ RubioR Gonz\u00e1lez-Garc\u00edaJ MirallesP P\u00e9rez-El\u00edasMJ OcampoA HernandoA EstradaV ClotetB PodzamczerD ArribasJR. 2009. Risk factors for loss of virological suppression in patients receiving lopinavir\/ritonavir monotherapy for maintenance of HIV suppression. Antivir. Ther. 14:195\u2013201.","journal-title":"Antivir. Ther"}],"container-title":["Antimicrobial Agents and Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.00315-13","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.00315-13","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,11]],"date-time":"2024-05-11T08:37:52Z","timestamp":1715416672000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/AAC.00315-13"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,8]]},"references-count":29,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2013,8]]}},"alternative-id":["10.1128\/AAC.00315-13"],"URL":"https:\/\/doi.org\/10.1128\/aac.00315-13","relation":{},"ISSN":["0066-4804","1098-6596"],"issn-type":[{"value":"0066-4804","type":"print"},{"value":"1098-6596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,8]]},"assertion":[{"value":"2013-02-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-05-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-07-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}