Welcome, Guest. Please login or register.
November 19, 2017, 07:34:53 AM

Login with username, password and session length

  • Total Posts: 722443
  • Total Topics: 58705
  • Online Today: 303
  • Online Ever: 1421
  • (August 13, 2016, 05:18:44 AM)
Users Online
Users: 4
Guests: 281
Total: 285


Welcome to the POZ Community Forums, a round-the-clock discussion area for people with HIV/AIDS, their friends/family/caregivers, and others concerned about HIV/AIDS.  Click on the links below to browse our various forums; scroll down for a glance at the most recent posts; or join in the conversation yourself by registering on the left side of this page.

Privacy Warning:  Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If you are HIV positive and disclose this in our forums, then it is almost the same thing as telling the whole world (or at least the World Wide Web). If this concerns you, then do not use a username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.

  • The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own physician.

  • All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.

  • Forums members must behave at all times with respect and honesty. Posting guidelines, including time-out and banning policies, have been established by the moderators of these forums. Click here for “Am I Infected?” posting guidelines. Click here for posting guidelines pertaining to all other POZ community forums.

  • We ask all forums members to provide references for health/medical/scientific information they provide, when it is not a personal experience being discussed. Please provide hyperlinks with full URLs or full citations of published works not available via the Internet. Additionally, all forums members must post information which are true and correct to their knowledge.

  • Product advertisement—including links; banners; editorial content; and clinical trial, study or survey participation—is strictly prohibited by forums members unless permission has been secured from POZ.

To change forums navigation language settings, click here (members only), Register now

Para cambiar sus preferencias de los foros en español, haz clic aquí (sólo miembros), Regístrate ahora

Finished Reading This? You can collapse this or any other box on this page by clicking the symbol in each box.

Author Topic: Reyataz less side-effects than Kaletra  (Read 2036 times)

0 Members and 1 Guest are viewing this topic.

Offline Ihavehope

  • Member
  • Posts: 1,366
  • Yes, I'm a cry baby, AND WHAT?
Reyataz less side-effects than Kaletra
« on: February 27, 2007, 02:49:21 PM »
Atazanavir (Reyataz) with low dose ritonavir is as effective as Kaletra (lopinavir/ritonavir) at suppressing viral load over two years in treatment-experienced patients when combined with tenofovir (Viread) and an NRTI, according to results from a study conducted by atazanavir’s manufacturer published in the March 21st edition of AIDS.

A favourable safety profile for atazanavir also emerged in the study. The investigators found that patients taking atazanavir were less likely to experience diarrhoea than individuals taking Kaletra and that atazanavir-treated patients had an improvement in their lipid profile from baseline whereas individuals on Kaletra experienced an increase in their blood fats and sugars.

BMS Study 045
Analysis of the first 48 weeks of the BMS Study 045 has been previously published. This showed that, in treatment- experienced individuals who had experienced virological failure on two earlier potent antiretroviral combinations, a regimen based on atazanavir/ritonavir was likely to achieve as large and durable a reduction in viral load as an antiretroviral regimen based upon Kaletra. Patients in both arms of the study also took tenofovir (Viread) and an NRTI, which, whenever possible, was selected by resistance testing. The trial was randomised, open-label and involved 347 individuals.

The investigators extended their analysis to 96 weeks. Once again, they wished to see if atazanavir/ritonavir achieved and maintained suppression of HIV comparable to Kaletra. They also had a number of secondary objectives. These included the number of patients in each arm of the study with a viral load below 400 copies/ml and 50 copies/ml after two years of treatment; and, the increase in CD4 cell count from baseline. They also wished to compare the safety and side-effect profile of the two study drugs.

96-week results
Over two years, atazanavir/ritonavir had comparable virologic efficacy to Kaletra. The mean reduction in viral load from baseline was – 2.29 log10 copies/ml amongst patients taking atazanavir/ritonavir and – 2.08 log10 amongst individuals randomised to take Kaletra. Similar proportions of patients in both arms of the study achieved a viral load below 400 copies/ml and 50 copies/ml.

Further analysis was conducted to see if the number of baseline protease inhibitor resistance mutations influenced the effectiveness of the two study medications. The investigators found that amongst patients with fewer than four resistance mutations, the median fall in viral load was – 2.47 log10 copies/ml in the atazanavir/ritonavir arm and – 2.21 log10 copies/ml in the Kaletra arm. If a patient had four or more protease inhibitor resistance mutations, the median reduction in viral load was – 1.71 log10 copies/ml if they were taking atazanavir/ritonavir and – 1.81 log10 copies/ml if they were taking Kaletra.

After 96 weeks of treatment, CD4 cell count had increased from baseline by 160 cells/mm3 in the atazanavir/ritonavir arm and by 142 cells/mm3 in the Kaletra arm. All differences were non-significant.

Safety and side-effects
The investigators then looked at the safety profile of the two drugs. Over the 96 weeks of the study, a severe adverse event was experienced by 13% of patients taking atazanavir/ritonavir and 11% of patients taking Kaletra. Two people taking Kaletra died as did one person taking atazanavir/ritonavir, but none of these deaths were related to the study medications.

Significantly more patients taking Kaletra (19%) experienced mild to severe gastrointestinal problems than those taking atazanavir/ritonavir (9%, p < 0.05). In addition, diarrhoea was more common amongst Kaletra-treated patients (13% vs 3%, p < 0.01).

Attention was then turned to the effect of the two study medications on patients’ lipid profiles. Two years of treatment with Kaletra resulted in a mean 9% increase in total cholesterol and a 30% increase in fasting triglycerides, whereas atazanavir/ritonavir-treated patients experienced a mean fall from baseline in total cholesterol of 3% and a 13% fall in fasting triglycerides (p < 0.0001).

As expected, jaundice and increases in bilirubin were associated with atazanavir treatment. A total of 53% of those taking atazanavir experienced a moderate to severe increase in their bilirubin compared to less than 1% of patients taking Kaletra. However, although there were a total of 29 cases of hyperbilirubinaemia amongst patients taking atazanavir, only five occurred during the second year of therapy with the drug, and nobody stopped treatment because of it.

The higher incidence of diarrhoea and lipid increases amongst the Kaletra-treated patients meant that these individuals were much more likely to require anti-diarrhoea treatment (25%) than those taking atazanavir/ritonavir (6%, p < 0.0001). Patients taking Kaletra were also significantly more likely to require lipid lowering therapy than individuals taking atazanavir/ritonavir (20% vs 9%, p < 0.05).

The investigators conclude that atazanavir/ritonavir showed comparable “durable efficacy to Kaletra and was not associated with unexpected or late-emerging adverse events” when used in combination with tenofovir and an NRTI in treatment-experienced patients. They add “the long-term use of atazanavir/ritonavir may decrease pill burden, improve tolerability and provide sustained virologic suppression for antiretroviral-experienced patients with HIV infection.”


Johnson M et al. 96-week comparison of once-daily atazanavir/ritonavir and twice-daily lopinavir/ritonavir in patients with multiple virologic failures. AIDS 20: 711 – 718, 2006.

aidsmap resources
Changing treatment
Palliative care
Salvage treatment
Changing treatments news
Previous poor adherence and HCV are risk factors for antiretroviral treatment failure
Is genetic screening for abacavir hypersensitivity risk appropriate for black Africans?
Continuing 3TC therapy after viral rebound shows no benefit
Palliative care news
Cannabis may be safe and effective for HIV-related neuropathic pain
Posaconazole successful in treating fluconazole- and itraconazole-resistant candidiasis
Large study finds no need to screen HIV-positive patients for thyroid disease
Salvage treatment news
After 48 weeks of study, and 24 weeks in the real world, darunavir continues to show staying power
Prezista (darunavir) approved for treatment-experienced patients in Europe
Pfizer announces expanded access programme for maraviroc
Side-effects news
CROI: Alendronate effectively treats bone loss in men and women with HIV
CROI: SMART analysis reveals slightly elevated risk of cardiovascular disease in people who interrupt therapy
Cannabis may be safe and effective for HIV-related neuropathic pain subscribe to aidsmap email bulletins


latest news
CROI: Tenofovir microbicide stops rectal infection in monkeys better than PrEP
CROI: Efavirenz-based ART more effective than nevirapine-based ART as first-line therapy in Southern Africa
CROI: SMART analysis reveals slightly elevated risk of cardiovascular disease in people who interrupt therapy
CROI: Alendronate effectively treats bone loss in men and women with HIV
CROI: Growth hormone stimulant TH9507 safe and effective in HIV lipodystrophy
CROI: Lower CD4 count on HIV treatment predicts higher risk of cancers, liver, kidney, cardiovascular disease
CROI: Urgent action needed to avert `catastrophic` drug-resistant TB epidemic
Poor infection control, not poor adherence, responsible for vast majority of drug-resistant TB in Chinese study
Health Canada issues warning on use of Baraclude alone in HIV/hepatitis B coinfected
Anti-herpes treatment reduces HIV levels; treatment or vaccine urged for HIV prevention


Support our work today



contact email update disclaimer copyright
Infected: April 2005
12/6/06 - Diagnosed HIV positive
12/19/06 - CD4 = 240  22% VL = 26,300
1/4/07 - CD4 = 200 16% VL = ?
2/9/07 = Started Kaletra/Truvada
3/13/07 = CD4 = 386 22% VL ?


Terms of Membership for these forums

© 2017 Smart + Strong. All Rights Reserved.   terms of use and your privacy
Smart + Strong® is a registered trademark of CDM Publishing, LLC.