title: Evaluation of boosted and unboosted atazanavir plasma concentration in HIV infected patients.
abstract: OBJECTIVE
  The aim of the study was to identify variables that can influence atazanavir plasma concentration.
  
  
  METHODS
  We retrospectively analysed atazanavir trough concentration of HIV infected patients who performed therapeutic drug monitoring between October 2007 and July 2011. Qualitative variables were compared with X(2) test while continuous ones with Mann-Whitney and Student's t-test. A linear regression model was used to investigate factors influencing atazanavir plasma concentration. Therefore, we analysed the impact of cirrhosis on atazanavir pharmacokinetic variability.
  
  
  RESULTS
  255 plasma samples from 179 patients were analysed. At the univariate analysis female gender (+144.4 ng/mL; p=0.05) and tenofovir (+196.8 ng/mL; p=0.002) were associated with higher atazanavir concentrations. The multivariate model confirmed these two variables (+164.6 ng/mL; p=0.02 and +150.4 ng/mL; p=0.01) as independently associated with higher atazanavir trough concentration. The analysis of cirrhotic population showed an influence of tenofovir (-255.9 ng/mL; p=0.01), increased AST (+95.3 ng/mL; p=0.09), ALT (+67.9 ng/mL; p=0.07) and creatinine (+517.2 ng/mL; p=0.04). The multivariate model confirm that tenofovir was associated with lower atazanavir trough concentration (-284.1 ng/mL; p=0.005) while AST values significantly increased atazanavir concentrations (+114.5 ng/mL; p=0.03).
  
  
  CONCLUSIONS
  Atazanavir is a safe and manageable drug. Our results suggest that female patients tend to have higher atazanavir plasma concentration, while the effect of tenofovir needs to be better clarified.
authors: Silvia
authors: S
authors: Amadasi
authors: Silvia
authors: S
authors: Odolini
authors: Emanuele
authors: E
authors: Foca
authors: Annafranca
authors: A
authors: Panzali
authors: Carlo
authors: C
authors: Cerini
authors: Lucia
authors: L
authors: Lonati
authors: Maria C
authors: MC
authors: Pezzoli
authors: Paola
authors: P
authors: Nasta
authors: Salvatore
authors: S
authors: Casari
authors: Francesco
authors: F
authors: Castelli
authors: University Division of Infectious and Tropical Diseases, University of Brescia, P.le Spedali Civili, 1 - 25123 Brescia, Italy. silvia.amadasi@live.it.
authors: Eugenia
authors: E
authors: Quiros-Roldan
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000493:pharmacokinetics*; D001219:Aspartate Aminotransferases / Q000097:blood; D000069446:Atazanavir Sulfate; D003404:Creatinine / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy; D017320:HIV Protease Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000009:adverse effects / Q000493:pharmacokinetics*; D011725:Pyridines / Q000009:adverse effects / Q000493:pharmacokinetics*; D012044:Regression Analysis; D012189:Retrospective Studies; D012737:Sex Factors
chemical_list: D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D009842:Oligopeptides; D011725:Pyridines; D000069446:Atazanavir Sulfate; D003404:Creatinine; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase