There is an ongoing need for potent antiretroviral
therapies to deal with the increasing pool of treatment-experienced patients with multiple drug resistance. The last few years have seen the arrival of 2 new and very potent
protease inhibitors -
darunavir and
tipranavir - alongside 2 whole new classes of
anti-HIV agents - the
integrase inhibitors and
chemokine receptor CCR5 antagonists. This review focuses on the role of
darunavir in managing
HIV infection, with an emphasis on
darunavir's exceptional resistance profile and related clinical effectiveness, pharmacokinetics, tolerability and toxicity data.
Darunavir in combination with the pharmacokinetic booster
ritonavir has proved to be very effective in the treatment of highly treatment-experienced HIV patients with multiple drug resistance. The favorable tolerability and toxicity profile alongside the
drug's high genetic barrier to the development of resistance prompted approval of
darunavir for HIV-treatment naïve patients. Furthermore, the paradigm of treating HIV with a combination of
anti-HIV agents is currently being challenged by ongoing
darunavir monotherapy trials and these preliminary data will be discussed.