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The Body Covers: The 41st Interscience Conference on Antimicrobial Agents and Chemotherapy
HIV Session I (Slide Session 071)

December 17, 2001

A note from TheBody.com: Since this article was written, the HIV pandemic has changed, as has our understanding of HIV/AIDS and its treatment. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

  • Comparative Results (Phase II 48-Week): BMS-232632, Stavudine, Lamivudine as HAART for Treatment-Naive HIV-Positive Patients (AI424-008)
    Abstract 667
    Authored by Ian Sanne (WHC Infectious Diseases Clinical Trials Unit, Johannesburg, South Africa), P. Cahn (Fundacion Huesped, Buenos Aires, Argentina), L. Percival (Bristol-Myers Squibb Company, Wallingford, CT), P. Phanuphak (Chulalongkorn University, Bangkok, Thailand), T. Kelleher (Bristol-Myers Squibb Company, Wallingford, CT), M. Giordano (Bristol-Myers Squibb Company, Wallingford, CT), G. Pantaleo (Centre Hospitalier Universitaire Vadois, Lausanne, Switzerland)
    View the original abstract


Atazanavir Outperforms Nelfinavir at 48 Weeks of Therapy

Atazanavir (BMS-232632) is an investigational protease inhibitor (PI) that has several potential advantages over the currently FDA-approved protease inhibitor, including its once-daily dosing schedule, low pill burden (two pills once daily) and the lack of adverse impact upon lipid profiles. Currently, atazanavir is in phase III trials.

BMS-008 compared atazanavir (400mg or 600mg) versus nelfinavir (Viracept) twice daily in combination with stavudine (Zerit) and lamivudine (Epivir). At baseline, the enrolled patients were antiretroviral-naive and the demographics between the two arms were similar, with baseline viral loads of approximately 4.77 log10 copies/mL.

Using an intent-to-treat analysis, 74 percent, 75 percent and 53 percent, achieved a viral load <400 copies/mL at 48 weeks. Under an on-treatment analysis, the viral load decline was similar in the three arms -- approximately 2.5 log10 copies/mL at 48 weeks -- and 74% of the patients on 400mg a day of atazanavir and 60% of the patients on viracept achieved a viral load <400 copies/mL. The three arms were equal in their suppression to <50 copies/mL and their rise in CD4+ T cell counts. Total cholesterol, LDL and triglycerides changed little in the atazanavir arms, while they rose significantly in the Viracept arm at 48 weeks. In addition, diarrhea was relatively common in the viracept arm (56 percent) and uncommon in the atazanavir arm (15-20 percent). Unconjugated hyperbilirubinemia occurred in <5 percent of patients and four patients required dose reduction.

This study indicates that atazanavir is at least comparable to nelfinavir in efficacy. Further, atazanavir's favorable lipid profile, ease of dosing and lower rate of diarrhea will provide an advantage over nelfinavir for many patients. Further studies of atazanavir are underway, comparing it to efavirenz (sustiva/stocrin) and kaletra (lopinavir/ritonavir), and additional data should be forthcoming regarding the effectiveness and tolerability of atazanavir HAART regimens.


A note from TheBody.com: Since this article was written, the HIV pandemic has changed, as has our understanding of HIV/AIDS and its treatment. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

See Also
HIV Medications: When to Start and What to Take -- A Guide From TheBody.com
More Research on First-Line HIV Treatment
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Please note: Knowledge about HIV changes rapidly. Note the date of this summary's publication, and before treating patients or employing any therapies described in these materials, verify all information independently. If you are a patient, please consult a doctor or other medical professional before acting on any of the information presented in this summary. For a complete listing of our most recent conference coverage, click here.

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