Related factors to atazanavir plasma levels in a cohort of HIV positive individuals with undetectable viral load.
OBJECTIVE
To evaluate the factors associated with plasma concentrations of atazanavir (ATV) in a cohort of well-controlled HIV infected subjects (undetectable viremia).


METHODS
Cross-sectional study where 69 subjects were consecutively enrolled between April and November, 2011.


METHODS
Patients had to be on atazanavir for at least six months, undetectable viral load for a period equal to or longer than 12 months, T CD4+ lymphocyte count higher than 200 cells/mm(3), and aged between 18 years and 70 years old. Exclusion criteria were pregnancy, any neurologic disease, active opportunistic disease, hepatitis or cancer. Atazanavir plasma levels were measured by ultra-performance liquid chromatography.


CONCLUSIONS
Overall, 54 patients (mean age of 47 years and 50% women) were included in the analysis. Those without ritonavir (unboosted atazanavir) had statistically lower plasma concentrations than those with ritonavir boosted atazanavir (p=0.001) and total and indirect bilirubin were statistically associated with plasma concentration of atazanavir (r=0.32 and r=0.33 respectively; p<0.05 in both cases). No statistical association was found among gender, ethnicity, age, weight, body mass index (BMI), lipid profile, and the plasma concentration of atazanavir.


CONCLUSIONS
In summary, as expected, concomitant ritonavir use was the only factor associated with atazanavir plasma levels. Prospective studies with a larger sample size might help to observe an association of atazanavir concentrations to other characteristics such as body weight, since the p-value showed to be close to significance (p=0.068).
Medical Sciences Course, Universidade Federal do Rio Grande do Sul (UFRS), Porto Alegre, RS, Brazil.
Ana Júlia
AJ
Luz
Júlia
J
Poeta
Rafael
R
Linden
Marina Venzon
MV
Antunes
Luiza Isola
LI
Caminha
Eduardo
E
Sprinz
D000293:Adolescent; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000097:blood* / Q000493:pharmacokinetics / Q000627:therapeutic use; D000069446:Atazanavir Sulfate; D018791:CD4 Lymphocyte Count; D002853:Chromatography, Liquid; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000188:drug therapy / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000097:blood* / Q000493:pharmacokinetics / Q000627:therapeutic use; D011446:Prospective Studies; D011725:Pyridines / Q000097:blood* / Q000493:pharmacokinetics / Q000627:therapeutic use; D019562:Viral Load; D055815:Young Adult
D019380:Anti-HIV Agents; D009842:Oligopeptides; D011725:Pyridines; D000069446:Atazanavir Sulfate
Atazanavir; Drug concentration; Lipid profile; Plasma levels; Ritonavir