A systematic review of the use of atazanavir in women infected with HIV-1.
BACKGROUND
Despite increasing numbers of women with HIV worldwide, females are under-represented in clinical trials of antiretrovirals and literature addressing gender differences in clinical outcomes, treatment discontinuation, adverse events and adherence are limited. Most recommendations specific to women in current guidelines relate to pregnant women or women wishing to become pregnant. The purpose of this systematic review is to provide clinicians with an overview of available literature regarding the use of ritonavir-boosted atazanavir (ATV/r) in women.


METHODS
The online databases PubMed and EMBASE, HIV-related conference abstracts and reference lists of relevant articles were searched according to predefined terms and limited to items published from 1 October 2007 to 1 October 2012. Updates to conference presentations were checked for substantive journal publication up to 28 November 2013.


RESULTS
Of the 294 initial citations retrieved, manual selection identified 19 relevant publications describing gender-based analyses of ATV/r. Publications describing gender-based differences in efficacy, safety, tolerability, pharmacokinetics, drug-drug interactions and adherence are critically evaluated.


CONCLUSIONS
As part of a combination antiretroviral therapy regimen, ATV/r appears to be a safe, effective and durable option for treatment-naive and early treatment-experienced patients with HIV-1 infection, including non-pregnant and pregnant women.
Royal Free Centre for HIV Medicine, Royal Free Hospital, London, UK. margaret.johnson1@nhs.net.
Margaret
M
Johnson
Sharon
S
Walmsley
Annette
A
Haberl
D000328:Adult; D019380:Anti-HIV Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000069446:Atazanavir Sulfate; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008297:Male; D009842:Oligopeptides / Q000493:pharmacokinetics / Q000627:therapeutic use*; D011247:Pregnancy; D011725:Pyridines / Q000493:pharmacokinetics / Q000627:therapeutic use*; D019438:Ritonavir / Q000493:pharmacokinetics / Q000627:therapeutic use*; D012737:Sex Factors; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects
D019380:Anti-HIV Agents; D009842:Oligopeptides; D011725:Pyridines; D000069446:Atazanavir Sulfate; D019438:Ritonavir