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Abstract
Objective: To assess virological efficacy of a ritonavir-boosted atazanavir (ATV/r)-containing regimen in patients with persistent viral replication despite HAART. Patients and Method: Prospective cohort of French HIV-infected patients. Patients were included if pretreated and viral load (VL) >400 copies/mL at the time of ATV/r first prescription (baseline). Demographic and epidemiologic data, therapeutic history, and clinical and biological values at baseline and during follow-up were analyzed. Primary endpoint was failure of the regimen defined as either VL >400 copies/mL at Week 24 or treatment interruption before Week 24. Multivariate analysis was performed of baseline characteristics related with treatment failure. Results: There were 424 patients with available data. Primary endpoint was met by 36%: 24% VL >400 copies/mL and 12% treatment interruption. Treatment interruption due to drug-related toxicity was significantly more frequent in women (20.5% vs. 8.8%, p = .001). Female gender (adjusted odds ratio [OR] = 1.91), previous use of lopinavir (LPV; OR = 2.76), number of new drugs and of active drugs in the regimen (OR = 0.48 and 0.3, respectively), and baseline VL (OR = 1.75) were independently related with treatment failure. Conclusion: ATV/r-containing regimens, because of low pill burden and good tolerance, can be a useful strategy as long as the patients did not suffer previous LPV failures. The issue of gender deserves further studies in larger populations.