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Atazanavir/Ritonavir Once-Daily Seen As Advantageous

It has similar efficacy as lopinavir/ritonavir twice-daily, but causes fewer gastrointestinal effects

MONDAY, Aug. 4 (HealthDay News) -- In treatment-naive HIV patients, treatment with atazanavir/ritonavir once-daily is as effective as treatment with lopinavir/ritonavir twice-daily, but its superior side effect profile suggests that it should be the preferred first-line treatment, according to an article published online Aug. 2 in The Lancet.

Jean-Michel Molina, M.D., of Hopital Saint-Louis in Paris, France, and colleagues randomly assigned 883 patients to receive either atazanavir/ritonavir once daily or lopinavir/ritonavir twice daily in combination with fixed-dose tenofovir/emtricitabine once daily.

After 48 weeks, the researchers found no significant group differences in the number of patients who achieved a viral load of less than 50 copies per mL (78 percent of those on the once-daily regimen versus 76 percent of those on the twice-daily regimen) or in mean increases from baseline in CD4 cell counts. They also found that significantly fewer patients on the once-daily regimen experienced grade 2-4 treatment-related diarrhea (2 percent versus 11 percent) and nausea (4 percent versus 8 percent). But more patients on the once-daily regimen experienced grade 3-4 increases in total bilirubin (34 percent versus less than 1 percent).

"The results of this study support the use of once-daily atazanavir/ritonavir as a recommended first-line treatment option, with a number of patient benefits over the currently recommended ritonavir-boosted twice-daily lopinavir for the treatment of HIV-infected antiretroviral-naive patients," the authors conclude.

This study was funded by Bristol-Myers Squibb, and several authors disclosed financial ties to it and other pharmaceutical companies.

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