Side Effects of atazanavir: A Synthesis of Findings from 26 Studies

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Original Abstract of the Article

Main Research Findings

Studies on the side effects of atazanavir have reported a variety of adverse effects. Here is a summary of the main findings.

  • 23 mentions the nephrotoxicity of atazanavir, suggesting the possibility of proteinuria.
  • 18 shows that atazanavir blood concentrations are not affected by gender.
  • 14 shows that patients are concerned about drug resistance, lipodystrophy, and gastrointestinal side effects as side effects of atazanavir.
  • 26 investigates the effect of atazanavir on immune reconstitution and suggests that it is effective in immune reconstitution compared to efavirenz or lopinavir/ritonavir.
  • 25 suggests that genetic testing before administration of atazanavir may help identify individuals at risk of side effects.
  • 17 suggests that atazanavir may have a significant impact on the hematopoietic system and cardiovascular system.
  • 1 investigates the effects of atazanavir on the liver at the genetic level and suggests that it may affect lipid metabolism.
  • 9 mentions the possibility of reducing side effects with atazanavir combination therapy.
  • 22 suggests a link between atazanavir's side effect of hyperbilirubinemia and genes.
  • mentions the possibility of adverse effects on the cardiovascular system as a side effect of atazanavir.
  • 2 mentions the possibility of an increased risk of kidney stones as a side effect of atazanavir.
  • 13 compares atazanavir's effects and side effects to lopinavir/ritonavir.
  • 16 compares atazanavir's effects on body composition to other protease inhibitors.
  • 3 shows, in animal studies, that atazanavir can lead to elevated blood lipid levels, reduced paraoxonase 1 activity, and increased homocysteine levels.
  • 11 suggests the safety and effectiveness of atazanavir for infants and children.
  • 12 investigates the effects of atazanavir on lipid metabolism in animal studies.
  • 24 compares the effects of atazanavir on metabolism to other antiretroviral drugs.
  • 20 suggests a link between atazanavir blood concentrations and rosuvastatin.
  • 21 suggests a link between atazanavir's side effect of hyperbilirubinemia and genes.
  • 9 mentions the possibility of reducing side effects with atazanavir combination therapy.
  • 22 suggests a link between atazanavir's side effect of hyperbilirubinemia and genes.

Reasons for Side Effects

The side effects of atazanavir are thought to be complexly related to a variety of factors, including the mechanism of action of the drug and the individual patient's constitution. For example, the effects of atazanavir on the liver are thought to be caused by inhibition of drug metabolism and biliary excretion in the liver. The effects of atazanavir on lipid metabolism are thought to be caused by interactions between the drug and enzymes and receptors involved in lipid metabolism.

Common Side Effects

Gastrointestinal

The effects of atazanavir on the gastrointestinal system have been reported in several studies. 14 shows that patients are concerned about gastrointestinal side effects as a side effect of atazanavir.

Metabolic

The effects of atazanavir on the metabolic system have been reported in several studies. 13 compares the effects of atazanavir on lipid metabolism to lopinavir/ritonavir. 16 compares the effects of atazanavir on body composition to other protease inhibitors. Also, 3 shows in animal studies that atazanavir can lead to elevated blood lipid levels.

Kidney

The effects of atazanavir on the kidneys have been reported in several studies. 23 mentions the nephrotoxicity of atazanavir, suggesting the possibility of proteinuria. 2 mentions the possibility of an increased risk of kidney stones as a side effect of atazanavir.

Liver

The effects of atazanavir on the liver have been reported in several studies. 22 suggests a link between atazanavir's side effect of hyperbilirubinemia and genes. Also, 1 investigates the effects of atazanavir on the liver at the genetic level.

Immune System

The effects of atazanavir on the immune system have been reported in several studies. 26 investigates the effects of atazanavir on immune reconstitution.

Other

Side effects of atazanavir, such as skin rash, jaundice, and fatigue have been reported.

Countermeasures to Side Effects

Gastrointestinal

It is important to make dietary changes and adjust drug administration methods to reduce gastrointestinal side effects of atazanavir. For example, taking atazanavir with meals or dividing the dose can reduce the burden on the gastrointestinal system. In some cases, the doctor may instruct you to stop taking the drug.

Metabolic

It is important to make lifestyle changes, such as healthy eating and exercise, to reduce the effects of atazanavir on metabolism. Your doctor may also prescribe treatment for conditions such as dyslipidemia.

Kidney

It is important to have regular blood and urine tests to reduce the effects of atazanavir on the kidneys. It is also important to drink plenty of fluids to avoid putting stress on the kidneys.

Liver

It is important to have regular blood tests to reduce the effects of atazanavir on the liver. Your doctor may also prescribe treatment to improve liver function. 21 suggests that genetic testing before administration of atazanavir may help predict the risk of hyperbilirubinemia.

Immune System

It is important to have regular blood tests to monitor immune status to reduce the effects of atazanavir on the immune system.

Comparison Between Studies

Commonalities

These studies report on a variety of side effects of atazanavir. One commonality is that the side effects of atazanavir can potentially affect a variety of organs, such as the gastrointestinal system, metabolic system, kidneys, liver, and immune system. These studies also suggest the need for countermeasures to reduce the side effects of atazanavir.

Differences

These studies differ in their study subjects and methods, so there are differences in their results. For example, 18 shows that atazanavir blood concentrations are not affected by gender. On the other hand, 20 suggests a link between atazanavir blood concentrations and rosuvastatin. These findings suggest that the side effects of atazanavir are affected by a variety of factors, including individual patient constitution and other drugs being taken.

Points to Note Regarding Application to Daily Life

Studies on the side effects of atazanavir provide a variety of important information. However, these study results are only research findings and do not apply to all patients. If you are considering taking atazanavir, always consult your doctor and choose a treatment that is right for you.

Limitations of Current Research

Research on the side effects of atazanavir is not yet complete. Further research is needed, especially on long-term side effects and the mechanisms by which side effects occur. Also, the influence of genetic factors on the side effects of atazanavir is not yet fully understood.

Future Research Directions

To better understand the side effects of atazanavir, long-term follow-up studies and research on the mechanisms by which side effects occur are needed. It is also important to investigate the influence of genetic factors on the side effects of atazanavir using new technologies such as genetic testing.

Conclusion

The side effects of atazanavir can potentially affect a variety of organs. If you are considering taking atazanavir, always consult your doctor and choose a treatment that is right for you. Research on the side effects of atazanavir is not yet complete. Further research is needed.

Literature analysis of 26 papers
Positive Content
20
Neutral Content
0
Negative Content
6
Article Type
3
1
1
9
26
1.

Gene expression profiling of rat liver reveals a mechanistic basis for ritonavir-induced hyperlipidemia.

Author: LumPek Yee, HeYudong D, SlatterJ Greg, WaringJeffrey F, ZelinskyNicollete, CavetGuy, DaiXudong, FongOlivia, GumRebecca, JinLixia, AdamsonGary E, RobertsChristopher J, OlsenDavid B, HazudaDaria J, UlrichRoger G

HIV treatment
Hepatic dysfunction

Ritonavir, a HIV protease inhibitor, was found to affect several key cellular pathways in the liver of rats. The drug upregulated genes involved in cholesterol and fatty acid biosynthesis and downregulated genes involved in their breakdown. Ritonavir also upregulated genes involved in proteasomal activity.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

2.

Drug-Induced Kidney Stones and Crystalline Nephropathy: Pathophysiology, Prevention and Treatment.

Author: DaudonMichel, FrochotVincent, BazinDominique, JungersPaul

nephrolithiasis prevention
drug-induced calculi
renal failure

Drug-induced renal calculi represent 1-2% of all cases. The drugs causing calculi can be divided into two groups: 1) poorly soluble drugs that crystallize in the urine, and 2) drugs that alter urinary pH or excretion of components like calcium, phosphate, or oxalate. This article discusses the most common drug culprits in each group and methods for diagnosis and prevention.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

4.

Atazanavir for treatment of HIV infection in clinical routine: efficacy, pharmacokinetics and safety.

Author: FeldtT, OetteMark, KroidlA, GöbelsK, LeidelR, SagirA, KuschakD, HäussingerD

Reduce viral load
Safe and effective HIV treatment
Side effects
Virologic failure

Atazanavir (ATV) treatment of HIV-infected patients with or without a ritonavir (RTV) booster was safe and effective in clinical routine, with drug levels sufficient in the majority of cases.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Management of antiretroviral drug toxicity.

Author: FeeneyEoin, MuldoonEavan, PowderlyWilliam G

Drug toxicity

The review discusses the current understanding of antiretroviral drug toxicity, a major concern in HIV treatment due to potential impact on adherence. It examines key recent data to inform strategies for managing and avoiding these toxicities.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

Post-exposure prophylaxis for HIV infection: a clinical trial comparing lopinavir/ritonavir versus atazanavir each with zidovudine/lamivudine.

Author: Diaz-BritoVicens, LeónAgathe, KnobelHernando, PeraireJoaquim, DomingoPere, ClotetBonaventura, DalmauDavid, CrucetaAnna, ArnaizJoan Albert, GatellJosep M, GarcíaFelipe,

PEP discontinuation

The rate of discontinuation of post-exposure prophylaxis (PEP) before day 28 was similar for both zidovudine/lamivudine plus lopinavir/ritonavir and zidovudine/lamivudine plus atazanavir. Adverse events were a reason for discontinuation or switching of PEP in a small percentage of patients. However, nearly 50% of patients experienced side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Planning HIV therapy to prevent future comorbidities: patient years for tenofovir alafenamide.

Author: ShafranS D, Di PerriG, EsserS, LelièvreJ-D, ParczewskiM

HIV treatment improvement
Improved safety profile

This study discusses the use of tenofovir alafenamide (TAF) as a safer alternative to tenofovir disoproxil fumarate (TDF) in antiretroviral therapy (ART) for HIV-infected patients. TAF has been shown to have improved renal and bone safety while maintaining efficacy, making it a preferred option for HIV patients, especially as the population ages and comorbidities become more common.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

10.

Meta-analysis on outcome-worsening comorbidities of COVID-19 and related potential drug-drug interactions.

Author: AwortweCharles, CascorbiIngolf

COVID-19 treatment
ADRs
Bleeding
QTc-time prolongation

Drug-drug interactions (DDIs) can occur when two or more medications are taken together. DDIs can change the way that drugs are absorbed, metabolized, or excreted, which can lead to adverse drug reactions (ADRs). This study investigated the potential DDIs between medications used to treat COVID-19 and medications used to manage underlying comorbidities. The study found that DDIs can occur between antiviral medications and drugs used to treat cardiovascular disease, chronic kidney disease, and chronic obstructive pulmonary disease. These DDIs can increase the risk of serious adverse events, such as cardiac injury, bleeding, and death. The study concluded that careful monitoring for adverse events is essential for patients with COVID-19 who are taking multiple medications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

11.

Safety and Efficacy of Atazanavir Powder and Ritonavir in HIV-1-Infected Infants and Children From 3 Months to <11 Years of Age: The PRINCE-2 Study.

Author: CottonMark F, LibertyAfaaf, Torres-EscobarIndiana, Gonzalez-TomeMaria Isabel, LissensJurgen, ZaruLuna, KlauckIsabelle, CambilargiuDaniela, PikoraCheryl, CorrellTodd A

HIV Treatment
Hyperbilirubinemia

Atazanavir powder formulation boosted with ritonavir (ATV + RTV) is a palatable and effective treatment option for HIV-1 infected children aged 3 months to <11 years. In a clinical trial, 83.8% of children remained on ATV powder until 24 weeks and 59.6% remained on it until 48 weeks. The most common adverse events were upper respiratory tract infections, gastroenteritis, vomiting, and hyperbilirubinemia. Virologic suppression rates were comparable across weight bands, with the lowest rate in the 5 to <10 kg = 200/80 mg group, likely due to higher baseline HIV-1 RNA and a higher discontinuation rate.

Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

First-line boosted protease inhibitor-based regimens in treatment-naive HIV-1-infected patients--making a good thing better.

Author: LlibreJosep M

HIV treatment
Hyperbilirubinemia

Atazanavir and darunavir showed superior virologic efficacy and better tolerability compared to lopinavir, making them suitable for first-line antiretroviral therapy in treatment-naive patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Patient preferences among third agent HIV medications: a US and German perspective.

Author: BeusterienK M, DziekanK, SchraderS, FloodE, FloodR, ShearerA, DavisE A

HIV treatment
Preference assessment
Drug resistance
Gastrointestinal side effects
Lipodystrophy

This study assessed patient preferences for third-agent HIV medications. Drug resistance, lipodystrophy risk, gastrointestinal side effects, and regimen convenience were the most important attributes influencing preferences. Fosamprenavir/ritonavir was the most preferred medication profile.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

15.

Broadening the perspective when assessing evidence on boosted protease inhibitor-based regimens for initial antiretroviral therapy.

Author: HornbergerJohn, SimpsonKit, ShewadeAshwini, DietzBirgitta, BaranRobert, PodsadeckiThomas

Long-term clinical and economic effectiveness

Lopinavir/ritonavir (LPV/r) has been a well-established boosted protease inhibitor (PI) for treatment-naïve HIV-infected patients, with the most evidence on long-term clinical and economic effectiveness. All PIs should not be viewed as equally safe and effective for all patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

Differential body composition effects of protease inhibitors recommended for initial treatment of HIV infection: a randomized clinical trial.

Author: MartinezEsteban, Gonzalez-CordonAna, FerrerElena, DomingoPere, NegredoEugenia, GutierrezFelix, PortillaJoaquin, CurranAdrià, PodzamczerDaniel, RiberaEsteban, MurillasJavier, BernardinoJose I, SantosIgnacio, CartonJose A, PeraireJoaquim, PichJudit, DeulofeuRamon, PerezIgnacio, GatellJose M,

Increased subcutaneous fat
Increased total fat
Increased triglycerides
Insulin resistance

Atazanavir/ritonavir led to higher triglycerides and more total and subcutaneous fat than darunavir/ritonavir. Both regimens were effective and had similar side effects.

Clinical Trial, Phase IVPost-marketing surveillance. Monitors long-term safety/efficacy after approval.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

17.

Identifying side effects of commonly used drugs in the treatment of Covid 19.

Author: Aygünİrfan, KayaMehmet, AlhajjReda

COVID-19 treatment
Drug interactions
Side effects

This study uses Graph Convolutional Networks to assess the drug-drug interactions of 8 drugs commonly used for COVID-19 treatment with 645 different drugs, estimating potential side effects. The findings highlight the risks associated with polypharmacy and emphasize the importance of careful drug selection in COVID-19 treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

18.

The steady-state pharmacokinetics of atazanavir/ritonavir in HIV-1-infected adult outpatients is not affected by gender-related co-factors.

Author: von HentigNils, BabacanErrol, LennemannTessa, KnechtGabi, CarlebachAmina, HarderSebastian, StaszewskiSchlomo, HaberlAnnette

Side effects

This study evaluated the pharmacokinetics of atazanavir/ritonavir in 48 male and 26 female HIV-1-infected adults.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

22.

Hyperbilirubinemia in atazanavir treated HIV-infected patients: the impact of the UGT1A1*28 allele.

Author: PanagopoulosPeriklis, MaltezosEfstathios, HatzakisAngelos, ParaskevisDimitrios

HIV treatment
Improved life expectancy
Drug side effects
Genetic susceptibility

Patients treated with atazanavir (ATV) boosted with ritonavir (rit) for HIV infection may experience elevated bilirubin levels. This side effect may be linked to genetic variations in the uridine diphosphate glucuronosyltransferase (UGT) enzyme, particularly the UGT1A1*28 variant. Pharmacogenetics/pharmacogenomics testing can help identify patients susceptible to this side effect and guide treatment decisions.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

23.

Proteinuria in paediatric patients with human immunodeficiency virus infection.

Author: GiacometVania, ErbaPaola, Di NelloFrancesca, ColettoSonia, ViganòAlessandra, ZuccottiGianvincenzo

Early detection of kidney injury
Nephrotoxicity

This review discusses the causes of proteinuria and other pathological findings related to kidney disease in HIV-infected children and adolescents.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

25.

Pharmacogenetics as a tool to tailor antiretroviral therapy: A review.

Author: AcetiAntonio, GianserraLaura, LambiaseLara, PennicaAlfredo, TetiElisabetta

HIV treatment personalization
Central nervous system side effects
Hyperbilirubinemia
Hypersensitivity reaction

Pharmacogenetics is becoming increasingly relevant in optimizing antiretroviral therapy for HIV patients. Genotyping for specific SNPs can help personalize treatment and prevent adverse drug reactions.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

26.

Immune Reconstitution in Severely Immunosuppressed Antiretroviral-Naive HIV-1-Infected Patients Starting Efavirenz, Lopinavir-Ritonavir, or Atazanavir-Ritonavir Plus Tenofovir/Emtricitabine: Final 48-Week Results (The Advanz-3 Trial).

Author: MiroJose M, ManzardoChristian, FerrerElena, LoncàMontserrat, GuardoAlberto C, PodzamczerDaniel, DomingoPere, CurranAdrian, ClotetBonaventura, CrucetaAnna, LozanoFrancisco, PérezIñaki, PlanaMontserrat, GatellJose M,

Immune reconstitution

This study compared an efavirenz-based regimen with 2 ritonavir-boosted protease inhibitor regimens in very immunosuppressed antiretroviral-naive, HIV-1-infected individuals.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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