Controversial approaches in HIV infection : Is there a role for lopinavir/ritonavir monotherapy?

Standard antiretroviral therapy typically consists of 3 active drugs. Preliminary results from pilot studies suggest that lopinavir/ritonavir monotherapy can achieve viral suppression for some antiretroviral therapy-naive patients and maintain viral suppression for some antiretroviral therapy-naive or protease inhibitor-naive patients. However, the available data are limited by small sample sizes, different study designs (only 1 randomized controlled trial), and short follow-up. Additional concerns include the possibility of inferior virologic outcomes and high viral rebound rates with lopinavir/ritonavir monotherapy compared with triple-antiretroviral regimens. The role of lopinavir/ritonavir monotherapy in HIV-infected patients remains unclear.