It has received accelerated approval from the FDA and has proven to be efficacious by decreasing viral RNA blood levels and increasing CD4 T-cell counts, particularly in combination with reverse transcriptase inhibitors. Nelfinavir is only the second protease inhibitor to be approved for use in the pediatric population. Differences in resistance patterns,side effect profiles, and drug interactions are likely to be the indicators for selecting a protease inhibitor until further information is available on this class of agents. The addition of nelfinavir provides another option for clinicians.
All protease inhibitors are currently on the Drug List.
The nelfinavir group also showed a clinically significant increase in CD4 count. Drug resistance has occurred in some patients receiving nelfinavir. The mechanism of this resistance is due to a genetic mutation which is different than the other protease inhibitors. At this point, it is unclear what effect this will have on cross-resistance. Studies are currently underway to further evaluate the effect nelfinavir may have on other protease inhibitors.