1. Debating The Merits of Monotherapy For HIV José Arribas, MD Laurent Cotte, MD Réjean Thomas, MD

2. Mathis S, et al. Effectiveness of protease inhibitor monotherapy versus combination antiretroviral maintenance therapy: a meta-analysis. PLoS One. 2011;6(7):e22003. Epub 2011 Jul 19. Risk ratios for maintaining viral suppression, intention to treat analysis, 48 week follow-up, viral suppression < 50 copies/ml

3. Monotherapy and Neurocognitive Impairment at CROI 2012 - Positive Results Paper #479 –NCI Prevalence (wk48): 30% in mono-LPV/r vs 32% in TDF/3TC/LPV/r (p = 0.85). –NCI Incidence 6% in mono-LPV/r vs 7% in TDF/3TC/LPV/r (p = 0.85). –No significant differences in neuropsychological tests Paper #483 –Undetectable CSF Viral Load CSF for all but 3 MT patients and in 1 HAART patient (18% vs 6%, p = 0.601). –NCI observed in 7 patients on MT and 10 patients on HAART (41% vs 59%; p = 0.494). –Global Deficit Score showed differences between groups, indicating better rates in MT group (0.23 [±0.20] vs 0.46 [±0.30]; p = 0.025) Bunupuradah T. et al. Neurocognitive Impairments in Patients Using Lopinavir/ritonavir Monotherapy vs Lopinavir/ritonavir-based HAART. CROI 2012 Paper #479 Santos J., et al. Long-term Monotherapy with Lopinavir/ritonavir (>2 Years) Is Not Associated with Greater HIV-associated Neurocognitive Impairment. CROI 2012 Paper #483

4. Monotherapy and Neurocognitive Impairment at CROI 2012 – Negative Results Paper #480 –Higher CSF levels of S100-beta (570 ± 1132) & neopterin (2.5 ± 2.9) in monotherapy (MT) versus conventional therapy (CT) (0 ± 532, p = 0.002 and 1.2 ± 2.5, p = 0.058, respectively) Du Pasquier R. et al. Rapid Increase of Astrocytic and Inflammatory Markers in the Cerebrospinal Fluid of HIV + Patients on Lopinavir/ritonavir Monotherapy. CROI 2012 Paper #480 MT CT MT CT S100-beta p=0.002 Neopterin p=0.058 MT CT MT CT S100-beta p=0.002 Neopterin p=0.058