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Updated: Jul 5, 2026
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Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors
Published on: April 9, 2014
Decrease of atazanavir and lopinavir plasma concentrations in a boosted double human immunodeficiency virus protease
Nils von Hentig1, Pavel Kaykhin, Christoph Stephan
1Pharmazentrum Frankfurt/ZAFES, Institute of Clinical Pharmacology, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany. Hentig@em.uni-frankfurt.de
Antimicrobial Agents and Chemotherapy
|April 16, 2008
Summary
The combination of atazanavir (ATV) and lopinavir-ritonavir in HIV patients did not show the expected drug enhancement. Instead, plasma concentrations of both ATV and lopinavir were slightly decreased, requiring careful patient selection and monitoring.
Area of Science:
- Pharmacokinetics
- Antiretroviral Therapy
- HIV Treatment
Background:
- The combination of atazanavir (ATV) and lopinavir-ritonavir is a protease inhibitor regimen used in HIV treatment.
- Previous reports suggested potential pharmacoenhancement between ATV and lopinavir, potentially benefiting salvage therapy patients.
- This study investigates the actual pharmacokinetic interaction of this specific drug combination.
Purpose of the Study:
- To evaluate the pharmacokinetic interaction of coadministered atazanavir (ATV) and lopinavir-ritonavir in human immunodeficiency virus (HIV) infected patients.
- To determine if the reported mutual pharmacoenhancement of plasma concentrations occurs in a real-world clinical setting.
- To provide data that can inform clinical decisions regarding the use of this combination therapy.
Main Methods:
- Retrospective analysis of pharmacokinetic data from 17 patients receiving ATV-lopinavir-ritonavir.
- Measurement and comparison of plasma concentrations of ATV and lopinavir in patients on the combination regimen.
- Statistical analysis to assess the significance of observed changes in drug concentrations.
Main Results:
- Plasma concentrations of both atazanavir (ATV) and lopinavir were found to be modestly decreased when coadministered.
- The observed decrease in drug concentrations was not statistically significant.
- The results conflict with previous reports suggesting mutual pharmacoenhancement.
Conclusions:
- The coadministration of atazanavir (ATV) and lopinavir-ritonavir did not result in the anticipated pharmacoenhancement.
- Patients receiving this regimen require careful selection due to potentially suboptimal drug concentrations.
- Frequent clinical and therapeutic drug monitoring is strongly recommended for patients on this combination therapy to ensure efficacy and safety.
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