atazanavir / Generic mfg. - LARVOL DELTA

Forecasting drug resistant HIV protease evolution. (PubMed, PLoS Comput Biol) - "Our analysis shows that the dual therapy of Atazanavir (ATV) and Ritonavir (RTV) is the multi-PI treatment regimen least likely to induce drug resistance. Interestingly, our results highlight the necessity of the amino-acid polymorphism of L63P by predicting that it is critical in developing resistance to Nelfinavir (NFV). The results validate that our framework effectively extracts and combines biological information from the distinct data sets of observed genotypes and drug resistance, while also tackling the challenge of sparsity of available sequence data compared to the large combinatorial complexity of protein evolution and changing functionality in dynamic environments."

Journal • Human Immunodeficiency Virus • Infectious Disease

A GPCR-G protein-β-arrestin megacomplex enabled by a versatile allosteric modulator. (PubMed, Cell) - "Remarkably, this compound, atazanavir, exhibits pan-receptor activation across multiple family A GPCRs, including GPR119, β1AR, and β2AR, demonstrating the broad applicability of this regulatory mechanism. This discovery uncovers a distinct mechanism of GPCR regulation, opening alternative avenues for the development of therapeutics targeting GPCRs."

Journal

Pure atazanavir kidney stone (PubMed, Rev Prat) - No abstract available

Journal • Nephrology • Renal Calculi

Development of a Physiologically Based Model of Bilirubin Metabolism in Health and Disease and Its Comparison With Real-World Data. (PubMed, CPT Pharmacometrics Syst Pharmacol) - "To also illustrate model behavior under targeted perturbations, we simulated administration of atazanavir in healthy individuals and patients with Gilbert syndrome to investigate its effect on bilirubin levels. Relative to baseline, unconjugated bilirubin maximum concentration (Cmax) increased by 34% in healthy individuals but by 67% in Gilbert syndrome. Overall, this study provides a conceptual and mechanistically informed framework for studying bilirubin homeostasis and the functional consequences of drug administration in health and disease."

Clinical • Journal • Real-world evidence • Gastrointestinal Disorder • Genetic Disorders • Hepatology • Metabolic Disorders

Neurodevelopmental Risk in HIV-Exposed Uninfected Children: Call for Developmental Surveillance. (PubMed, J Pediatr Perinatol Child Health) - "This review underscores the need to integrate neurodevelopmental surveillance into pediatric HIV-exposed care, optimize anti-retroviral therapy regimens with consideration of fetal outcomes, and support caregiver- and community-based interventions that promote healthy development. Addressing the developmental needs of HEU children is critical to improving long-term outcomes and ensuring this growing population is not left behind."

Journal • Developmental Disorders • Human Immunodeficiency Virus • Infectious Disease • Pediatrics

PSD04 Recurrent and persistent genital ulcers in an immunocompromised man: an uncommon presentation of herpes zoster. (PubMed, Br J Dermatol) - "He is currently on an oral daily dose of tenofovir 300 mg, lamivudine 300 mg, dolutegravir 50 mg, atazanavir 300 mg and ritonavir 100 mg...Complete resolution was obtained with a higher dose of aciclovir appropriate for VZV infection...This case was interesting because VZV as an aetiological agent for persistent genital ulcers has not previously been reported to the best of our knowledge. Clinical consideration of such a unique presentation of VZV is important for timely diagnosis and appropriate management, especially in immunocompromised individuals, to avoid possible complication of repeated treatment for HSV infection."

Journal • Cytomegalovirus Infection • Herpes Simplex • Herpes Zoster • Human Immunodeficiency Virus • Infectious Disease • Pain • Varicella Zoster • CD4

Hearing Measures in Children Perinatally HIV-exposed and Uninfected in the PHACS SMARTT Study. (PubMed, Pediatr Infect Dis J) - "While SNHL was relatively common, there were no consistent associations between in utero ARV exposure and SNHL or incomplete DPOAEs. Further research is needed on ARV exposures and other hearing measures in CHEU."

Journal • Human Immunodeficiency Virus • Infectious Disease • Otorhinolaryngology

Prevalence and correlates of hyperbilirubinemia among people living with HIV (PLHIV) receiving atazanavir boosted with ritonavir (ATV/r). (PubMed, BMC Gastroenterol) - "There was a high prevalence of indirect hyperbilirubinemia, with a significant proportion experiencing grade 3-4 elevations. Although no statistically significant associations were observed, it would be valuable to investigate potential genetic predispositions that may make certain individuals more susceptible to developing high-grade hyperbilirubinemia on ATV/r."

Journal • Human Immunodeficiency Virus • Infectious Disease

Coadministration of a crystalline drug compromises supersaturation and membrane transport of an amorphous drug. (PubMed, Int J Pharm) - "Non-sink dissolution studies were conducted for a physical mixture of amorphous atazanavir and crystalline darunavir. This suggests that water facilitated mixing of the drugs in the colloidal phase, which affected the release and membrane transport properties of atazanavir. These findings further illustrate the complexity of formulating or co-administrating multicomponent drugs, even when present in different solid forms, and provide new insights into how amorphous drugs behave when co-administered with crystalline drugs."

Journal

Validation of a highly sensitive assay for the determination of rivastigmine in human plasma for pharmacokinetic studies. (PubMed, J Chromatogr B Analyt Technol Biomed Life Sci) - "The internal standard used was atazanavir-d5. The total analysis time per sample was only 3 min. This method was successfully applied to determine the pharmacokinetic parameters of rivastigmine after a single oral dose of 1.5 mg (capsules) in 26 healthy volunteers."

Journal • PK/PD data

Overcoming barriers in care: managing HIV in people with disabilities (EACS 2025) - "A change in the posology was proposed, and the Infectologist prescribed Ritonavir and Atazanavir, protease inhibitors, and Lamivudine + Tenofovir. The main finding of this research was that the attention and care provided by the hospital and the pharmaceutical team were essential for effective treatment. As a result, the elderly man achieved an undetectable viral load. Challenges may arise, but with empathy, knowledge, and combined effort, a multidisciplinary team can effectively manage the care of people living with HIV."

Human Immunodeficiency Virus • Infectious Disease

Antiviral exposure and risk of Metabolic Dysfunction-Associated Steatotic Liver Disease (EACS 2025) - "Cumulative bictegravir (linear P -value=0.009, quadratic P -value=0.047) and tenofovir alafenamide (TAF) (linear P -value=0.039, quadratic P -value=0.026) exposure showed inverse-U shaped associations...Current use of nevirapine showed lower odds of MASLD (aOR=0.26, 95%CI (0.08-0.85)). Cumulative exposure to boosted atazanavir , was associated with higher odds of MASLD (aOR=1.09, 95%CI (1.01-1.18)). Conclusions : Our findings suggest associations between exposure to contemporarily used ART and presence of MASLD in PWH. Prospective studies examining the effect of these therapies on MASLD development and progression are warranted."

Human Immunodeficiency Virus • Infectious Disease

Antimicrobial potential of compounds from the MMV pandemic response box and COVID box against carbapenem-resistant Acinetobacter baumannii. (PubMed, Braz J Microbiol) - "Additionally, their effects on biofilm inhibition, protein leakage, and synergy with meropenem were assessed. Among the tested compounds, 10 demonstrated notable antimicrobial activity, including doxycycline, atazanavir, alexidine, eravacycline, erythromycin, gepotidacin, trimetrexate, MMV1634402 (brilacidin), MMV1580854 and MMV1578564...The present study highlights the antimicrobial activity of MMV1634402 (brilacidin) and gepotidacin, providing preliminary evidence of their potential as therapeutic candidates against CRAB. However, further studies involving a broader range of isolates and clinical validation are essential to confirm their efficacy and safety."

Journal • Infectious Disease • Malaria • Novel Coronavirus Disease

Population pharmacokinetics of ritonavir as a booster of lopinavir, atazanavir, or darunavir in African children with HIV. (PubMed, Antimicrob Agents Chemother) - "We conducted a pharmacokinetic sub-study within the CHAPAS-4 (ISRCTN22964075) trial, which randomized children to two NRTIs with twice-daily lopinavir/ritonavir, once-daily atazanavir/ritonavir, or once-daily darunavir/ritonavir, as second-line ART. Ritonavir exposure is higher with atazanavir than with lopinavir or darunavir. These data provide greater insight into the use of ritonavir for boosting PIs in children and help reduce the knowledge gap regarding its exposure in children."

Journal • PK/PD data • Human Immunodeficiency Virus • Infectious Disease • Pediatrics

Efficacy and safety of emtricitabine/tenofovir alafenamide (F/TAF) plus cobicistat-boosted protease inhibitors in children with HIV-1 aged 2-<12 years and weighing 14-<40 kg: Week 48 outcomes (IAS-HIV 2025) - P2/3 | "BACKGROUND: TAF is a nucleoside reverse transcriptase inhibitor with improved renal and bone safety compared with tenofovir disoproxil fumarate. F/TAF is approved in Europe and the US for use with boosted protease inhibitors in adults and older children, and is being evaluated with cobicistat-boosted atazanavir (ATV/co) or darunavir (DRV/co) in younger children in an ongoing open-label Phase 2/3 trial (NCT02016924)... Over 48 weeks of treatment, F/TAF + ATV/co or DRV/co in children aged 2-<12 years and weighing 14-<40 kg maintained high rates of virologic suppression, with an acceptable safety profile. There were no renal, bone, or weight gain/loss concerns, supporting further evaluation of these drug combinations in pediatric populations."

Clinical • Hepatology • Human Immunodeficiency Virus • Infectious Disease • Pediatrics

Model-based evaluation of the interaction between ritonavir-boosted atazanavir and rifampicin in Ugandan adults with HIV. (PubMed, Br J Clin Pharmacol) - P2/3 | "Metabolic induction by rifampicin accounts for the decrease in plasma exposure of ATV/r. Doubling the ATV/r dosing frequency to BID effectively mitigated this interaction. The plasma exposure of ATV/r mirrored that in PBMCs, suggesting that for these drugs, plasma concentrations provide a reliable reflection of site-of-action exposures."

Journal • Human Immunodeficiency Virus • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Bictegravir, emtricitabine, and tenofovir alafenamide versus ritonavir-boosted protease inhibitor-based antiretroviral therapy in people with HIV and viral suppression on second-line therapy in Haiti: an open-label, randomised, non-inferiority trial. (PubMed, Lancet HIV) - P4 | "Switching adults with HIV and viral suppression on a second-line boosted protease inhibitor-based regimen to combination bictegravir, emtricitabine, and tenofovir alafenamide is non-inferior to continuing boosted protease inhibitor-based antiretroviral therapy. These findings support international treatment guideline recommendations to use second-generation integrase inhibitors for treatment-experienced patients."

Clinical • Head-to-Head • Journal • Human Immunodeficiency Virus • Infectious Disease

Untargeted Metabolite Profile Associations with Body Mass Index, Waist-Hip Ratio, and Antiretroviral Therapy in >1300 People with HIV: the Swiss HIV Cohort Study. (PubMed, J Infect Dis) - "In PWH from Switzerland, untargeted metabolite profiling revealed multiple unreported associations with different ART agents, and previously reported associations with BMI."

Journal • Genetic Disorders • Human Immunodeficiency Virus • Infectious Disease • Obesity

Pregnancy and health outcomes among women living with HIV on different antiretroviral therapy in Malawi: a cohort study (IAS-HIV 2025) - "Women in both cohorts had similar pregnancy outcomes, but Cohort B experienced a higher frequency of Atazanavir and Zidovudine- associated clinical and laboratory events compared to those in Cohort C. These results emphasize importance of consistent ART management and monitoring to improve maternal and neonatal health outcomes."

Clinical • HEOR • Human Immunodeficiency Virus • Infectious Disease

Prevalence and durability of viral suppression among adults living with HIV transitioned from boosted protease inhibitors-based to dolutegravir-based regimens as second-line therapy from 2019 to 2021 in Tajikistan (IAS-HIV 2025) - "BACKGROUND: WHO recommends dolutegravir-based regimens (DBR) as preferred second-line therapy for those failing efavirenz-based regimens (EBRs) but there was no guidance on whether those who failed EBR and were switched to boosted protease inhibitor-based therapy (bPIBR) could be transitioned to DBRs. In Tajikistan, DBRs, primarily tenofovir/lamivudine/dolutegravir (TLD), became available in 2019...Median time on ART before TLD was 5 years (IQR:3-6) and on bPIBRs 1 year (IQR:1-2); 63% used lopinavir- and 35% atazanavir-based regimens; tenofovir was part of backbone regimen for 46% of PLHIV... Transitioning from second-line bPIBRs to TLD resulted in high rates of DVS among most PLHIV, including those previously suppressed and unsuppressed on bPIBRs. Our results suggest that transition from second-line bPIBR to DBRs may be an effective practice. Further investigation is needed to identify reasons for non-suppression among some PLHIV transitioned from second-line bPIBRs to..."

Clinical • Human Immunodeficiency Virus • Infectious Disease

Osteosimply014: Simplification From Tenofovir Plus Lamivudine or Emtricitabine Plus Ritonavir-Boosted-Protease Inhibitor to Ritonavir-Boosted-Atazanavir Plus Lamivudine in Virologically-Suppressed-HIVInfected Adults With Osteopenia (clinicaltrials.gov) - P=N/A | N=31 | Completed | Sponsor: Judit Pich | Unknown status ➔ Completed | N=45 ➔ 31

Enrollment change • Trial completion • Human Immunodeficiency Virus • Infectious Disease • B2M

Bictegravir decreases expression of system L-amino acid transporters and inhibits leucine uptake activity in a human placental cell line. (PubMed, Biomed Pharmacother) - "Syncytialized BeWo cells were treated with atazanavir, darunavir, efavirenz, dolutegravir, raltegravir, bictegravir or cabotegravir for 24 h at Cmax and half Cmax therapeutic concentrations. Bictegravir, which has been recently added to perinatal treatment guidelines, was associated with downregulation of system L expression and function in BeWo cells. Further in vivo studies are warranted to confirm our findings."

Journal • Preclinical • Human Immunodeficiency Virus • Infectious Disease

Forecasting drug resistant HIV protease evolution. (PubMed, bioRxiv) - "We infer drug resistance along simulated evolutionary paths and predict that the combination PI-therapy of Atazanavir (ATV) and Ritonavir (RTV) is the least drug resistant. Without prior knowledge of PI-associated mutations, our model predicts known primary and secondary PI-resistant mutations as critical to drug resistance. This validates that our model learned mechanistic relations in the small data sets, tackling the challenge of sparse sequence data compared to the large combinatorial complexity of protein evolution and changing functionality in dynamic environments."

Journal • Human Immunodeficiency Virus • Infectious Disease

Prenatal Antiretroviral Exposure and Concomitant Neurodevelopmental Problems among 5-year-old Children who are HIV-Exposed and Uninfected. (PubMed, J Acquir Immune Defic Syndr) - "Prenatal exposure to TDF/emtricitabine/atazanavir was associated with factor scores reflecting parent-reported behavioral concerns among CHEU whose mothers initiated ARVs during pregnancy."

Journal • Human Immunodeficiency Virus • Infectious Disease

HIV protease inhibitors restore amphotericin B activity against Candida. (PubMed, PLoS One) - "In this study, we identified four HIV protease inhibitors (atazanavir, saquinavir, lopinavir and ritonavir) as strong potentiators of amphotericin B against C. auris. The in vivo treatment with HIV protease inhibitors combined with amphotericin B resulted in a significant reduction of C. auris colony-forming units (CFU) by 1.7-2.6 Log10 in the C. elegans model. These findings suggest that HIV protease inhibitors, in combination with amphotericin B, are promising candidates for the development of novel antifungal drugs to treat Candida infections."

Journal • Candidiasis • Human Immunodeficiency Virus • Infectious Disease