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Updated: Aug 9, 2026

Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors
Published on: April 9, 2014
Early clinical experience with atazanavir in treatment-experienced patients
Sarangapany Jeganathan1, Don Smith, Julian Gold
1AAlbion Street Centre, 150-154, Albion Street, Surry Hills, NSW 2010, Australia. sarangapanyj@sesahs.nsw.gov.au
Background:
Atazanavir (ATV) is a newly approved protease inhibitor following successful clinical trials in naive and treatment-experienced patients. We describe early experience with ATV in treatment-experienced patients attending a single ambulatory care clinic in Sydney.
Methods:
Patients commencing ATV between February 2003 and May 2004 in an expanded access program were identified from the clinic pharmacy's database. Data were retrospectively collected from patients' medical records.
Results:
Data from 30 patients were analysed. Reasons for commencing ATV were: virological failure in six patients (20%); toxicity to previous regimen in 13 patients (43%); simplification strategy in two patients (7%); and recommencing therapy in nine patients (30%) following treatment interruption. Six patients (20%) discontinued ATV. One patient discontinued ATV due to virological failure, two patients discontinued due to toxicity to concomitant antiretrovirals, two as a result of the patient's choice and one as a result of the physician's decision. Eighteen patients commenced ATV in combination therapy with a detectable viral load (VL). From a baseline VL of 4.3 +/- 1.1 log10 copies mL(-1), 15 (83%) had > 1.0 log decrease in VL with 11 (61%) achieving viral suppression (<50 copies mL(-1)). Three (16%) failures were recorded in this group. Twelve subjects commenced ATV with an undetectable VL. One failure was recorded in this group. Bilirubin increased by 22.7 micromol L(-1) (P < 0.001), with significant decreases in cholesterol (1.4 mmol L(-1), P = 0.01) and triglycerides (1.5 mmol L(-1), P = 0.01) in 12 patients on ritonavir-boosted ATV.
Conclusion:
This audit found ATV to be safe, well tolerated and had good potency in treatment-experienced patients. However caution should be exercised in switching to ATV in heavily pre-treated patients.
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