[Therapeutic strategies for HIV infection: tolerance to boost antiproteases]

As tolerance not only depends on protease inhibitors (PI) dosing but also on their trough concentrations, the enhanced exposure associated with PI boosting goes together with a reduced tolerance, especially at the biological level. Moreover, the toxicity associated with the low doses ritonavir used in boosting seems to compromise, at least partly, the favourable metabolic profile of certain PI. Eventually, boosted lopinavir tolerance is similar to that of other PI. Even if the advantage/risk ratio of lopinavir or other boosted PI globally seems favourable, the final choice belongs to the physician in charge of evaluating the individual risk of a lesser, especially metabolic tolerance, for his or her patient.