{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:41:09Z","timestamp":1777927269354,"version":"3.51.4"},"reference-count":10,"publisher":"SAGE Publications","issue":"13","license":[{"start":{"date-parts":[[2019,10,20]],"date-time":"2019-10-20T00:00:00Z","timestamp":1571529600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:p>Multidrug-resistant (MDR) HIV can be complicated to manage. Patients are often on a high pill burden regimen, taking antiretrovirals twice daily, and often have other comorbidities. This study is a case report of a patient living with MDR HIV, and considerations are taken into account when simplifying the patient from a ten-pill regimen to a unique and unconventional six-pill regimen. The patient was living with HIV\/AIDS with an MDR virus on a five-tablet, twice-daily (ten total pill burden) regimen who was simplified to a unique and novel regimen of elvitegravir\/cobicistat\/emtricitabine\/tenofovir alafenamide\u2009+\u2009darunavir 600\u2009mg twice daily\u2009+\u2009cobicistat\u2009+\u2009maraviroc twice daily. This unique regimen, which decreased the patient\u2019s HIV pill burden from ten to six, has maintained virologic suppression 1 year after his antiretroviral therapy transition. When consolidating therapy in patients with MDR HIV, one regimen will not fit each individual patient. Our case demonstrates unique and unconventional dosing of darunavir 600\u2009mg along with cobicistat as twice-daily pharmacokinetic enhancing which assisted in consolidating our patient\u2019s regimen by a 40% decrease in pill burden. This change most importantly maintained virologic suppression and provides evidence for a potential option for similar patients with MDR HIV.<\/jats:p>","DOI":"10.1177\/0956462419841130","type":"journal-article","created":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T01:35:32Z","timestamp":1571621732000},"page":"1333-1336","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Simplification of ART in a patient living with multidrug resistant HIV-1: A case report using twice daily cobicistat and darunavir"],"prefix":"10.1177","volume":"30","author":[{"given":"Marisa B","family":"Brizzi","sequence":"first","affiliation":[{"name":"Section of Infectious Diseases Pharmacotherapy, Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard M","family":"Novak","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Immunology and Internal Medicine, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8385-4391","authenticated-orcid":false,"given":"Thomas D","family":"Chiampas","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases Pharmacotherapy, Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,10,20]]},"reference":[{"key":"bibr1-0956462419841130","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001193"},{"key":"bibr2-0956462419841130","doi-asserted-by":"publisher","DOI":"10.1086\/503914"},{"key":"bibr3-0956462419841130","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.11.3478-3484.2003"},{"key":"bibr4-0956462419841130","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1177\/135965350300800107","volume":"8","author":"Zaccarelli M","year":"2003","journal-title":"Antivir Ther"},{"key":"bibr5-0956462419841130","unstructured":"Panel on antiretroviral guidelines for adults and adolescents. Guidelines for the use of antiretroviral agents in adults and adolescents living with HIV. Department of Health and Human Services, http:\/\/aidsinfo.nih.gov\/contentfiles\/lvguidelines\/AdultandAdolescentGL.pdf (accessed 20 March 2019)."},{"key":"bibr6-0956462419841130","unstructured":"Centers for Disease Control and Prevention. Evidence of HIV treatment and viral suppression in preventing the sexual transmission of HIV, www.cdc.gov\/hiv\/risk\/art\/index.html (accessed 20 March 2019)."},{"key":"bibr7-0956462419841130","unstructured":"Tybost (cobicistat) (package insert). Foster City: Gilead Sciences, Inc., July 2018."},{"key":"bibr8-0956462419841130","unstructured":"Ramanathan S, Wang H, Szwarcberg J, et\u00a0al. Safety\/Tolerability, Pharmacokinetics and Boosting of Twice-daily Cobicistat Administered Alone or in Combination with Darunavir or Tipranavir (Presentation Abstract #P_08).\n                      Presented at the 13th International Workshop on Clinical Pharmacology of HIV Therapy\n                      , 16\u201318 April 2012, Barcelona, Spain."},{"key":"bibr9-0956462419841130","doi-asserted-by":"publisher","DOI":"10.2165\/11584570-000000000-00000"},{"key":"bibr10-0956462419841130","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.2008.168"}],"container-title":["International Journal of STD &amp; AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0956462419841130","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0956462419841130","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0956462419841130","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:39:24Z","timestamp":1777675164000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0956462419841130"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,20]]},"references-count":10,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1177\/0956462419841130"],"URL":"https:\/\/doi.org\/10.1177\/0956462419841130","relation":{},"ISSN":["0956-4624","1758-1052"],"issn-type":[{"value":"0956-4624","type":"print"},{"value":"1758-1052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,20]]}}}