In people with HIV/AIDS (PHAs) whose initial protease inhibitor–containing regimen no longer works, doctors may prescribe dual protease inhibitor (PI) regimens where one PI boosts the level of the other PI used in the combination. This has the advantage of increasing levels of the boosted PI in the blood (to prolong its anti-HIV activity) and reducing the number of times that pills need to be taken daily. In one study, researchers in Buenos Aires examined the effect of taking atazanavir in order to boost saquinavir levels in PHAs whose previous PI-based regimen no longer worked.
Researchers recruited 85 adults and randomly assigned them to receive the following PI combinations along with two nukes:
Subjects had a viral load ranging between 1,000 and 100,000 copies and at least 100 CD4+ cells.
On average, viral load decreases were slightly greater among subjects receiving ritonavir-saquinavir than those receiving atazanavir-saquinavir. Increases in CD4+ cell counts were also greater in subjects receiving ritonavir-saquinavir. However, on average, levels of triglycerides and cholesterol declined in atazanavir users, while increasing in ritonavir users. PHAs who use atazanavir may have a lower risk of developing cardiovascular disease than those who use ritonavir and possibly other protease inhibitors.
REFERENCE
Has D, Zala C, Schrader S, et al. Once-daily atazanavir plus saquinavir favourable affects total cholesterol (TC) and fasting triglyceride (TG) profiles in patients failing prior PI therapy (Trial AI424-009), Wk 24). Late-breaking abstract 16 - 41st annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago, 16–19 December 2001
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