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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Efficacy and safety of unboosted atazanavir in combination with lamivudine and didanosine in naive HIV type 1 patients in Senegal
AIDS Research and Human Retroviruses, Volume 26, No. 5, Year 2010
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Description
The use of ritonavir as a protease inhibitor boost is rare in sub-Saharan Africa because a heat-stable formula is not available. We report the results of an open-label pilot trial with unboosted atazanavir in combination with lamivudine and didanosine as first-line therapy conducted in Senegal. Treatment-naive HIV-1 infected adult patients without active opportunistic disease were included. The primary endpoint was the proportion of patients with plasma HIV-1 RNA <400 copies/ml at week 48. Forty patients (12 men and 28 women; mean age±SD: 40±9 years) were included. Treatment was changed during the study for two patients (pregnancy, tuberculosis); one patient was lost to follow-up and one patient died (gastroenteritis with cachexia). At week 48, 78% [95% confidence interval (CI): 65-90%] and 68% (95% CI: 53-82%) of the patients had HIV-1 RNA <400 and <50 copies/ml, respectively (intent-to-treat analysis; not completer=failure). Among the seven patients with HIV-1 RNA ≥400 copies/ml at week 48, five were not compliant; genotyping analysis (n=4) did not reveal a major mutation for protease inhibitors. The mean CD4 cell count change from baseline to week 48 was +238±79 cells/mm 3. The combination of unboosted atazanavir with lamivudine and didanosine was efficient and well tolerated in HIV-1-infected patients with results similar to those observed in Northern countries. These results suggest that unboosted atazanavir with its high genetic barrier could be a valuable alternative to NNRTIs in resource-limited countries in some HIV-1-infected patients in case of compliance issues with NNRTIs, intolerance to NNRTIs, resistance mutations to NNRTIs, in women with childbearing potential, or as a maintenance therapy in patients with virological suppression. © Copyright 2010, Mary Ann Liebert, Inc.
Authors & Co-Authors
Landman, Roland
France, Paris
Hôpital Bichat-claude-bernard Ap-hp
Diallo, Mamadou Baila
Senegal, Dakar
Fann University Teaching Hospital
Guèye, Ndèye Fatou Ngom
Senegal, Dakar
Fann University Teaching Hospital
Kane, Coumba Touré
Senegal, Dakar
Centre Hospitalier Universitaire Aristide le Dantec de Dakar
Mboup, Souleymane
Senegal, Dakar
Centre Hospitalier Universitaire Aristide le Dantec de Dakar
Fall, Mame Basty Koita
Senegal, Dakar
Fann University Teaching Hospital
Ndiaye, Barra K.
Senegal, Dakar
Fann University Teaching Hospital
Peytavin, Gilles
France, Paris
Hôpital Bichat-claude-bernard Ap-hp
Bennai, Yacia
United States, New York
Bristol-myers Squibb
Benalycherif, Aïda
France, Paris
Hôpital Bichat-claude-bernard Ap-hp
Girard, Pierre Marie
France, Paris
Hôpital Bichat-claude-bernard Ap-hp
France, Paris
Hôpital Saint-antoine
Sow, Papa Salif
Senegal, Dakar
Fann University Teaching Hospital
Statistics
Citations: 12
Authors: 12
Affiliations: 5
Identifiers
Doi:
10.1089/aid.2009.0123
ISSN:
08892229
Research Areas
Cancer
Genetics And Genomics
Health System And Policy
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cohort Study
Study Locations
Senegal
Participants Gender
Male
Female