HIV/AIDS HAART: Atazanavir clearance increases when used in combination with certain antiretrovirals

AIDSWEEKLY Plus; Monday, September 11, 2006
Staff Medical Writers

According to recent research from France, "The influence of nevirapine, efavirenz and tenofovir coadministration on ritonavir-boosted atazanavir pharmacokinetics was investigated in HIV (human immunodeficiency virus)-infected patients. A population pharmacokinetic analysis was performed in the context of therapeutic drug monitoring (87 patients, 121 samples)."

"A significant increase of atazanavir clearance (Cl/F) was found when either tenofovir (group B), efavirenz (group C), or nevirapine (group D) were co administered with atazanavir/ritonavir in comparison with patients treated with atazanavir/ritonavir and nucleoside reverse transcriptase inhibitors (group A): 6.24±0.36 L h^-1 (group A) versus 7.42±0.25 L h^-1 (group B) versus 9.60±0.27 l h^-1 (group C) versus 17.53±0.57 L h^-1 (group D) (p<0.001)," reported scientists.

"However," said E. Dailly and colleagues at Hopital Hotel Dieu in Nantes, "the decrease of the mean trough plasma concentration of atazanavir was significant only in group D: 1.02±0.86 mg/L (group A) versus 0.21±013 mg/L (group D) (p<0.001)."

The authors concluded, "The increase in atazanavir clearance when it is used in combination with nevirapine, efavirenz and/or tenofovir suggests that therapeutic drug monitoring of atazanavir should be performed in such circumstances."

Dailly and colleagues published their study in European Journal of Clinical Pharmacology (Influence of tenofovir, nevirapine and efavirenz on ritonavir-boosted atazanavir pharmacokinetics in HIV-infected patients. Eur J Clin Pharmacol. 2006 Jul;62(7):523-6).

For additional information, contact E. Dailly, Hopital Hotel Dieu, Dept. of Clinic Pharmacology, 9 Quai Moncousu, F-44093 Nantes, France.

Publisher contact information for the European Journal of Clinical Pharmacology is: Springer, 233 Spring Street, New York, NY 10013, USA.

Keywords: Nantes, France, HIV/AIDS, Atazanavir, Drug-Drug Interactions, Pharmacokinetics, Therapeutic Drug Monitoring.

This article was prepared by AIDS Weekly editors from staff and other reports.

Reference

Dailly E, Tribut O, Tattevin P, et al., “Influence of tenofovir, nevirapine and efavirenz on ritonavir-boosted atazanavir pharmacokinetics in HIV-infected patients”, Eur J Clin Pharmacol. 2006 Jul;62(7):523-6.

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