title: Brief Report: Switch to Ritonavir-Boosted Atazanavir Plus Raltegravir in Virologically Suppressed Patients With HIV-1 Infection: A Randomized Pilot Study.
abstract: This open-label, multinational, pilot study randomized (1:2 ratio) adults with HIV-1 RNA <40 copies per milliliter and nucleos(t)ide-related safety/tolerability issues to switch to ritonavir-boosted atazanavir (ATV/r) plus tenofovir disoproxil fumarate/emtricitabine (n = 37) or the nucleos(t)ide reverse transcriptase inhibitor-sparing regimen of ATV/r plus raltegravir (RAL) (n = 72). At 24 weeks, 35/37 (94.6%) and 58/72 (80.6%) of patients, respectively, maintained virological suppression, the primary endpoint, and 1 (2.7%) and 7 (9.7%), respectively, experienced virological rebound. Corresponding 48-week proportions were 86.5%, 69.4%, 2.7%, and 12.5%, respectively. Adherence was lower and treatment discontinuation was higher with ATV/r+RAL. In conclusion, switching to ATV/r+RAL resulted in a higher virological rebound rate than switching to ATV/r plus tenofovir disoproxil fumarate/emtricitabine.
authors.affiliation: *Infectious Diseases Unit, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; †ViiV Healthcare, Brentford, United Kingdom; ‡Chelsea and Westminster NHS Foundation Trust Hospital, London, United Kingdom; §Infectious Diseases & AIDS Units, Clinical Institute of Medicine & Dermatology, Hospital Clinic, University of Barcelona, Barcelona, Spain; ‖National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Roma, Italy; ¶Bristol-Myers Squibb, Rueil-Malmaison, France; #Bristol-Myers Squibb, Madrid, Spain; **Bristol-Myers Squibb, Uxbridge, United Kingdom; ††Triple O Research Institute PA, West Palm Beach, FL; ‡‡Bristol-Myers Squibb, Princeton, NJ; §§Department of Infectious and Tropical Diseases, Hôpital St Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France; and ‖‖Institut Pierre-Louis d'Epidémiologie et Santé Publique, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche en Santé n°1136, Paris, France.
authors.forename: Jan
authors.initials: J
authors.lastname: van Lunzen
authors.forename: Anton
authors.initials: A
authors.lastname: Pozniak
authors.forename: Jose M
authors.initials: JM
authors.lastname: Gatell
authors.forename: Andrea
authors.initials: A
authors.lastname: Antinori
authors.forename: Isabelle
authors.initials: I
authors.lastname: Klauck
authors.forename: Oscar
authors.initials: O
authors.lastname: Serrano
authors.forename: Adyb
authors.initials: A
authors.lastname: Baakili
authors.forename: Olayemi
authors.initials: O
authors.lastname: Osiyemi
authors.forename: Heather
authors.initials: H
authors.lastname: Sevinsky
authors.forename: Pierre-Marie
authors.initials: PM
authors.lastname: Girard
mesh_terms: D000328:Adult; D000069446:Atazanavir Sulfate / Q000627:therapeutic use*; D057915:Drug Substitution; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D019428:HIV Integrase Inhibitors / Q000627:therapeutic use*; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D000068898:Raltegravir Potassium / Q000627:therapeutic use*; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D019438:Ritonavir / Q000627:therapeutic use*; D019562:Viral Load; D055815:Young Adult
chemical_list: D019428:HIV Integrase Inhibitors; D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors; D000068898:Raltegravir Potassium; D000069446:Atazanavir Sulfate; D019438:Ritonavir