Dr. Ian Sanne, of South Africa, presented data from a large study using 464 HIV positive subjects to compare the effect of the following two protease inhibitors (PIs) :

• atazanavir – 400 mg or 600 mg once daily
• nelfinavir (Viracept) – 1,250 mg twice daily

Both drugs were taken along with regular doses of the following nukes:

• 3TC (lamivudine, Epivir)
• d4T (stavudine, Zerit)

All subjects enrolled in this study (called Trial 008) had never been previously exposed to anti-HIV drugs. At the start of the study, subjects had the following profile:

• average CD4+ count – about 270 cells
• average viral load – about 50,000 copies

Results

After one year, in one analysis, the proportion of subjects with viral loads below the 400 copy mark was as follows:

• atazanavir 400 mg – 64%
• atazanavir 600 mg – 67%
• nelfinavir – 53%

On average, the increase in CD4+ counts — about 200 cells — was similar in each group. The average increase in cholesterol (compared to pre-study levels) in all subjects on atazanavir and nelfinavir was as follows:

• atazanavir – 5%
• nelfinavir – 25%

The average increase in triglyceride levels compared to pre-study levels was as follows:

• atazanavir – 5%
• nelfinavir – 17%

Side effects

After one year, higher-than-normal levels of bilirubin developed in the following proportion of subjects:

• atazanavir – 17%
• nelfinavir – fewer than 1%

The proportion of subjects with diarrhea was as follows:

• atazanavir – 17%
• nelfinavir – 56%

Readers should bear in mind that subjects in this study had not previously used anti-HIV drugs. Results may therefore be different in PHAs who have been exposed to such drugs and who then proceed to use atazanavir. This drug is currently being tested in clinical trials in Canada, the countries of the European Union and South Africa.

REFERENCE

Sanne I, Cahn P, Percival L, et al. Comparative results (Phase II 48-week): BMS-232632, stavudine, lamivudine as HAART for treatment-naïve HIV+ patients (AI424-008). Abstract I-667 - 41st annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago, 16–19 December 2001

20020131
CATE12410

Copyright © 2002 - TreatmentUpdate. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Editor, The Canadian AIDS Treatment Information Exchange, 555 Richmond St. West, Suite 505, Box 1104, Toronto, ON, M5V 3B1 • Phone: 416-203-7122 • Toll Free: 1-800-263-1638 • Fax: 416-203-8284  http://www.catie.ca.

AEGiS is made possible through unrestricted grants from Boehringer Ingelheim, Elton John AIDS Foundation, iMetrikus, Inc., the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2002. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2002. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.