Nelfinavir may theoretically be used as the first protease inhibitor for some patients, reserving other agents for later use. Nelfinavir has been approved for pediatric patients. However, its immunological and virological efficacy in this population is still unknown. More studies in this age group will be essential to define its role in the management of HIV infection in children, particularly in those under 2 years of age. To date, there are no data from comparative trials between nelfinavir and other protease inhibitors, when used with NRTIs.
Clinical trials are either underway or are being planned.
Since reported studies with all marketed protease inhibitors enrolled different patient populations, used various combinations of concomitant NRTIs, and utilized different viral load assays for determining virological responses, it is not possible to directly compare the results from these studies. Thus, the relative clinical, immunologic, and virologic potencies of all these agents are not yet known. We wish to thank Michael Polis, M.D., M.P.H. for reviewing the article on nelfinavir and acknowledge Alice Pau, Pharm. D. for her contribution to this issue of Pharmacy Update.