Lopinavir/ritonavir is the first and only coformulated HIV-1 protease inhibitor (PI). Large clinical trials have demonstrated lopinavir/ritonavir’s clinical efficacy in both antiretroviral-naïve and -experienced patients. The immunologic and virologic benefits of treatment with this agent have been proven in HIV-infected adults, adolescents, and children. Smaller studies support the use of lopinavir/ritonavir monotherapy as a therapeutic option in certain patients. The drug is characterized by a high genetic barrier to resistance, and appears to be more forgiving of non-adherence than earlier, unboosted PIs. The most frequent side effects observed are diarrhea, nausea, and vomiting. These gastrointestinal adverse effects are generally mild to moderate. Metabolic derangements, including hyperlipidemia and glucose intolerance, have also been observed in lopinavir/ritonavir recipients. As the menu of available antiretroviral agents continues to expand, lopinavir/ritonavir remains a proven and effective drug for the treatment of HIV infection.
“Child, child, have patience and belief, for life is many days, and each present hour will pass away. Son, son, you have been mad and drunken, furious and wild, filled with hatred and despair, and all the dark confusions of the soul – but so have we. You found the earth too great for your one life, you found your brain and sinew smaller than the hunger and desire that fed on them – but it has been this way with all men. You have stumbled on in darkness, you have been pulled in opposite directions, you have faltered, you have missed the way, but, child, this is the chronicle of the earth. And now, because you have known madness and despair, and because you will grow desperate again before you come to evening, we who have stormed the ramparts of the furious earth and been hurled back, we who have been maddened by the unknowable and bitter mystery of love, we who have hungered after fame and savored all of life, the tumult, pain, and frenzy, and now sit quietly by our windows watching all that henceforth never more shall touch us – we call upon you to take heart, for we can swear to you that these things pass.”