atazanavir/ritonavir / Generic mfg. - LARVOL DELTA

Atazanavir/Ritonavir-Associated Erythema Multiforme in an HIV-1-Positive Patient. (PubMed, Cureus) - "The patient was receiving tenofovir, lamivudine, and dolutegravir; however, owing to a supply chain issue, dolutegravir was substituted with atazanavir/ritonavir. The Naranjo probability score indicated a probable adverse drug reaction. This case highlights the importance of recognizing EM as a potential adverse reaction to atazanavir and of early drug withdrawal to prevent progression to more severe cutaneous adverse reactions, including Stevens-Johnson syndrome."

Journal • Dermatology • Hematological Disorders • Human Immunodeficiency Virus • Infectious Disease • Steven-Johnson Syndrome

Breastmilk transfer and infant exposure to atazanavir/ritonavir in breastfeeding women with HIV: results from IMPAACT 2026. (PubMed, Front Reprod Health) - "No maternal adverse events occurred; three infants experienced unrelated grade 2 events. In this cohort, ATV and RTV were detectable in maternal plasma and breastmilk but not in infant plasma, with low RID estimates and a favorable safety profile."

Journal • Human Immunodeficiency Virus • Infectious Disease • Pediatrics

Longitudinal Clinical and Molecular Characterization of a Single Pediatric Case of Vertically Acquired HIV-1 Subtype C with Baseline Resistance to Protease Inhibitors. (PubMed, Microorganisms) - "Stanford HIVdb predicted high-level resistance to lopinavir/ritonavir, atazanavir/ritonavir, lamivudine, and emtricitabine; low-level resistance to darunavir/ritonavir and abacavir; and preserved susceptibility to tenofovir, zidovudine, and the evaluated NNRTIs...Following treatment optimization with an integrase inhibitor-based regimen and subsequent transition to bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF), HIV-1 RNA became Target Not Detected (TND) from November 2024 onward. At the latest follow-up, the CD4 count was 877 cells/µL, the CD8 count was 722 cells/µL, and the CD4:CD8 ratio had improved to 1.21, indicating substantial immune recovery. This single-patient case highlights the clinical value of baseline genotypic resistance testing and individualized, genotype-guided antiretroviral therapy in achieving durable virological suppression in pediatric HIV."

Journal • Human Immunodeficiency Virus • Infectious Disease • Pediatrics • CD4 • CD8

Pharmacokinetic Properties of Antiretroviral and Anti-Tuberculosis Drugs During Pregnancy and Postpartum (clinicaltrials.gov) - P=N/A | N=205 | Terminated | Sponsor: National Institute of Allergy and Infectious Diseases (NIAID) | Completed ➔ Terminated; The study was closed to accrual early based on Study Monitoring Committee review indicating that the study objectives had either been achieved or could not be met within a reasonable timeframe for the then-open arms.

Trial termination • Human Immunodeficiency Virus • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Autoimmune hemolytic anemia in people living with HIV: distinct clinical presentations, triggers, and outcomes in three adult cases (AIDS 2026) - " Case 1: 38-year-old with advanced immunosuppression receiving tenofovir, lamivudine, and dolutegravir (TDF/3TC/DTG), presented with acute neurological symptoms, fever, dark urine, and profound anemia...Treatment with high-dose prednisone, rituximab, and paclitaxel resulted in complete clinical and hematologic remission without transfusion. Case 2: 40-year-old with poor ART adherence on TDF/3TC and atazanavir/ritonavir developed transfusion-refractory wAIHA following a self-limited human metapneumovirus pulmonary infection. He exhibited persistent hemolysis with IgG DAT positivity and improved progressively after methylprednisolone pulse therapy, intravenous immunoglobulin, and ART optimization with darunavir-based therapy... These cases illustrate the heterogeneity, severity, and prognostic variability of AIHA in PLWH. Viral infections and lymphoproliferative disorders emerged as relevant triggers. Early recognition and subtype-specific management are essential, as..."

Clinical • Anemia • Autoimmune Hemolytic Anemia • Complement-mediated Rare Disorders • Hematological Disorders • Human Immunodeficiency Virus • Immunology • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Septic Shock

National cross-sectional survey on acquired HIV drug resistance in Haiti in 2023: warnings resistance to dolutegravir (AIDS 2026) - "3.77% of HIVs were resistant to dolutegravir and bictegravir, 4.4% to cabotegravir, 4.72% to raltegravir, and 5.03% to elvitegravir. Additionally, 15.19% of the viral strains were resistant to abacavir, 13.92% to lamivudine and emtricitabine, 6.65% to zidovudine, 8.23% to stavudine and didanosine, and 4.13% to tenofovir...Furthermore, some HIVs strains developed resistance against efavirenz (49.37%), nevirapine (50%), Rilpivirine (20.25%), Etravirine (12.66%), and doravirine (3.61%). Finally, HIV genome resistance was 0.63% against atazanavir/ritonavir and indinavir/ritonavir, 0.95% against lopinavir/ritonavir and 0.32% against darunavir/ritonavir. HIV acquired pharmacoresistance is moderate in Haiti and requires innovating adapted strategy for preventing its development, its transmission, and for protecting PLHIV health, while emphasizing on children and male individuals."

Human Immunodeficiency Virus • Infectious Disease • Respiratory Diseases

Virologic failure on dolutegravir‑based second‑line ART: real‑world outcomes from Harare, Zimbabwe (AIDS 2026) - " We conducted a retrospective cohort study of PLWH who switched from protease-inhibitor (PI)-based ART (atazanavir/r or lopinavir/r) to DTG-based ART between January 2019 and June 2025...We describe the outcomes among participants who continued DTG after adherence support and those who were switched to darunavir (DRV)-containing third-line therapy... Most participants achieved re-suppression on DTG-based ART following adherence support, without switching to third-line therapy. Fewer than half of those with genotypic results showed evidence of emergent DTG resistance. These findings highlight the continued importance of adherence counselling in managing PLWH with a history of treatment failure."

Clinical • Real-world • Real-world evidence • Human Immunodeficiency Virus • Infectious Disease

Dolutegravir coverage and viral suppression among adolescents and young adults living with HIV in Africa: findings from nine nationally-representative surveys, 2019-2023 (AIDS 2026) - "ALWH aged 15-24 years (sample n = 1827) were categorized into one of three mutually exclusive treatment groups: DTG-based regimen, non-DTG-based regimens (Efavirenz, Atazanavir/ritonavir, Nevirapine, Lopinavir/ritonavir); and not currently on any treatment. DTG-based regimen is superior to other ART options in achieving viral load suppression in adolescents. To reach global targets, programs should continue prioritizing DTG-based ART while intensifying efforts to initiate treatment for all individuals currently not on ART. Additionally, population-based viral suppression for ALWH on DTG remains lower than observed in clinical trials."

Clinical • Human Immunodeficiency Virus • Infectious Disease

Predictive factors of low-level viremia in people living with HIV: a case–control study in Colombia (AIDS 2026) - "Older age, high baseline viral load, and initiation with Atazanavir/ritonavir were associated with increased risk of LLV, whereas a higher CD4/CD8 ratio and Dolutegravir-based regimens were protective. These findings highlight the importance of individualized ART strategies and immunological monitoring to reduce the risk of LLV and improve long-term outcomes in PLWH."

Biomarker • Clinical • Human Immunodeficiency Virus • Infectious Disease • CD4 • CD8

Population pharmacokinetics of ritonavir-boosted atazanavir in subsequent-line treatment in African children with HIV. (PubMed, Antimicrob Agents Chemother) - P=N/A | "We investigated the effect of weight, age, atazanavir formulation, ritonavir dose, and NRTI backbone (tenofovir alafenamide [TAF]-emtricitabine, abacavir-lamivudine, or zidovudine-lamivudine). When simulating pharmacokinetics during rifampicin co-treatment, twice-daily atazanavir/r is expected to restore exposures to levels comparable to once-daily dosing without rifampicin. These findings provide a framework for future clinical evaluation in children with HIV and tuberculosis."

Journal • PK/PD data • Human Immunodeficiency Virus • Infectious Disease • Pediatrics • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Major protease inhibitor drug resistance mutations among patients with virological failure on second-line antiretroviral therapy in Zimbabwe: a retrospective cross-sectional study. (PubMed, Virol J) - "Major PI DRMs and multiclass HIVDR were common among PLWH with VF on PI-based second-line ART. Routine VL monitoring and early resistance testing are needed to detect and guide second-line ART failure in Zimbabwe."

Journal • Observational data • Retrospective data • Human Immunodeficiency Virus • Infectious Disease

Pharmacogenomics of current antiretroviral drugs. (PubMed, Pharmacogenomics) - "We searched Pharmacogenomics Knowledgebase (PharmGKB®) for abacavir, tenofovir disoproxil fumarate, tenofovir alafenamide, lamivudine, emtricitabine, dolutegravir, elvitegravir, raltegravir, bictegravir, cabotegravir, atazanavir/ritonavir, darunavir/ritonavir, lopinavir/ritonavir, lenacapavir, rilpivirine and doravirine. Actionable pharmacogenetic associations with antiretroviral drugs remain limited to abacavir. Future research should prioritize replicating pharmacogenetic associations across diverse populations and establishing clinical relevance."

Biomarker • Journal • Review • Human Immunodeficiency Virus • Infectious Disease • HLA-B • UGT1A1

Timeliness of switching to second-line antiretroviral therapy following virologic failure in Dar es Salaam, Tanzania. (PubMed, BMC Res Notes) - "The most common second-line regimen was Tenofovir + Emtricitabine + Atazanavir/ritonavir (38.8%)...No statistically significant associations were found between timely switching and sociodemographic or clinical factors. Conclusively, more than 25% of patients experienced delayed switching, indicating suboptimal adherence to WHO-recommended timelines in the studied clinics."

Journal • Human Immunodeficiency Virus • Infectious Disease

Body Composition Changes in Children Living With HIV Initiated on Dolutegravir or Protease Inhibitors in the CHAPAS-4 Trial. (PubMed, Pediatr Infect Dis J) - "DTG and ATV/r were associated with greater gains in fat-free mass and muscle mass than LPV/r, while DRV/r, TAF and prior nevirapine exposure were associated with fat mass accrual. Fat gain may initially reflect return to health but sustained increases may have metabolic implications. These findings suggest the need to monitor fat compartments with long-term exposure."

Journal • Human Immunodeficiency Virus • Infectious Disease • CD4

Longitudinal changes in bone mineral density among children living with HIV over 96 weeks following switch to second-line antiretroviral therapy in Uganda. (PubMed, PLOS Glob Public Health) - "CLWH aged 3-15 years switched to second-line ART including tenofovir alafenamide fumarate-emtricitabine (TAF/FTC) or standard-of-care (SOC) (abacavir (ABC) or zidovudine (ZDV) with dolutegravir (DTG), atazanavir/ritonavir (ATV/r), darunavir/ritonavir (DRV/r) or lopinavir/ritonavir (LPV/r)...-0.30,95% CI: -0.46, -0.15], p < 0.001) and first-line nevirapine (NVP) exposure (-0.25,95% CI: -0.43, -0.06, p = 0.009)...Smaller declines in TBLH BMD were associated with higher baseline fat mass, higher LS HA BMD, and use of DRV/r, DTG, or ATV/r compared with LPV/r. These findings emphasize the importance of ART selection and body composition in supporting bone health among CLWH."

Journal • Human Immunodeficiency Virus • Infectious Disease • CD4

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

Insights from systematic reviews (2019-2024) and drug interaction database analysis in people with HIV and comorbidities. (PubMed, Int J STD AIDS) - "Severe adverse drug reactions associated with ARTs, including efavirenz, darunavir, nevirapine, and atazanavir-ritonavir, especially when combined with treatments for TB and malaria. Key interactions included reduced drug levels from rifampicin and QT prolongation from artemether-lumefantrine...Database discrepancies were noted, especially for riociguat interactions and ritonavir through inhibition of P-gp or OATP1B1 functions.ConclusionsDDIs in PWH receiving ART with comorbidities have highlighted the crucial need for personalized treatment. Incorporating pharmacokinetic, pharmacodynamic, and pharmacogenomic factors is essential for optimizing therapy outcomes."

Journal • Cardiovascular • Human Immunodeficiency Virus • Hypertension • Infectious Disease • Malaria • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Bictegravir/emtricitabine/tenofovir alafenamide fixed-dose combination in advanced HIV disease. (PubMed, Medicina (B Aires)) - "B/F/TAF demonstrated excellent persistence, safety, and adequate VS rates in PLWH with AHD, including both TN and TE patients, supporting its use in this population."

Journal • Observational data • Retrospective data • Human Immunodeficiency Virus • Infectious Disease • CD4

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

Pharmacokinetic Properties of Antiretroviral and Anti-Tuberculosis Drugs During Pregnancy and Postpartum (clinicaltrials.gov) - P=N/A | N=205 | Completed | Sponsor: National Institute of Allergy and Infectious Diseases (NIAID) | Active, not recruiting ➔ Completed

Trial completion • Human Immunodeficiency Virus • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

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

Antiretroviral-specific associations between bone hormonal changes and treatment induced weight gain. (PubMed, AIDS) - "This study suggests links between bone-derived hormones and ART induced weight gain in PWH and demonstrates that this relationship is influenced by specific antiretrovirals."

Journal • Human Immunodeficiency Virus • Infectious Disease • CD4 • LCN2

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

HIV drug resistance, early treatment outcomes and impact of guidelines compliance after protease inhibitor-based second-line failure in a dedicated resistance clinic in western Kenya: a retrospective cohort study. (PubMed, J Int AIDS Soc) - "We found high levels of drug resistance and early VF following PI-based second-line failure in Kenya. Treatment guidelines compliance and switches to third-line, even within guidelines recommendations, improved early viral outcomes. Findings highlight the vulnerability of PLWH with advanced ART experience and resistance profiles, and the importance of following guidelines and improving access to third-line and drug resistance testing, particularly in the new ART era."

Compliance • Journal • Retrospective data • Human Immunodeficiency Virus • Infectious Disease

Pharmacokinetic data of atazanavir/ritonavir in second-line treatment of children living with HIV. (PubMed, J Acquir Immune Defic Syndr) - "This nested pharmacokinetic sub-study shows that children weighing 14-24.9 kg and >25 kg taking ATV/r 200/75 mg and 300/100 mg respectively, achieve concentrations comparable to those that are safe and effective in adults."

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