With only about one-quarter of Americans living with HIV being virally suppressed, more Americans becoming newly infected each year, and an aging cohort of HIV specialty care providers (who started providing care to HIV infected persons in the 1980’s), it is essential that health professional training programs incorporate curricula and experience regarding HIV prevention, diagnosis, care, and treatment.
Cobicistat is a derivative of ritonavir and a potent inhibitor of CYP3A. As does ritonavir, it "boosts" blood levels of other substrates of this enzyme but, unlike ritonavir, it has no activity against HIV. It has been developed as a pharmacokinetic enhancer of the integrase inhibitor elvitegravir and of some PIs.
Rilpivirine and Boceprevir
Boceprevir (BOC) is a hepatitis C virus (HCV) NS3/4A protease inhibitor used in combination with pegylated interferon + ribavirin for the treatment of HCV. As BOC is an inhibitor of hepatic cytochrome (CYP) 3A4, and many protease inhibitors and NNRTIs affect or are affected by this hepatic isoenzyme, interactions are expected.
It has been demonstrated previously that ritonavir significantly increases serum levels of inhaled and intranasal fluticasone and that coadministration with fluticasone should be avoided. Few studies have examined interactions between PIs and other corticosteroids. At the 19th Conference on Retroviruses and Opportunistic Infections, researchers presented results from a randomized controlled PK study of interactions of both darunavir/ritonavir and ritonavir (alone) with inhaled beclomethasone.