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Double HIV Protease Inhibitor Regimen Safe, Effective

Pilot study shows higher serum protease inhibitor levels and reduced viral load at 24 weeks

THURSDAY, May 18 (HealthDay News) -- A double-boosted protease inhibitor regimen consisting of atazanavir and lopinavir/ritonavir yield good tolerability and substantial antiviral efficacy in HIV-infected adults, according to a report in the May 12 issue of AIDS.

Esteban Ribera, M.D., from the Hospital Universitari Vall d'Hebron in Barcelona, Spain, and colleagues conducted a non-randomized, open-label pilot study to assess the pharmacokinetics and tolerability of lopinavir, ritonavir and atazanavir.

Higher maximal concentrations and area under the curve values for lopinavir were achieved when combined with ritonavir and atazanavir, compared with just lopinavir and ritonavir, or lopinavir/ritonavir and saquinavir. Atazanavir concentrations, however, were not different when combined with lopinavir and ritonavir, or ritonavir alone. At 24 weeks, viral loads were less than 50 copies per mL in 13 of 16 patients receiving the double-boosted regimen.

"The combination of atazanavir and lopinavir/ritonavir provided high plasma concentrations of both protease inhibitors, which seemed to be appropriate for patients with multiple prior therapeutic failures, yielding good tolerability and substantial antiviral efficacy," the authors conclude.

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