Is atazanavir best when boosted with ritonavir?
Report from the 7th International Workshop on Clinical Pharmacology of HIV Therapy, 20–22 April 2006, Lisbon, Portugal Nearly all protease inhibitors have some impact on lipids (fats)—cholesterol and triglycerides—and often raise their levels in the blood. Over time, increased lipid levels can pose a health risk by narrowing blood vessels and laying the groundwork for heart attacks, strokes and diabetes. Atazanavir (Reyataz) may be unique among protease inhibitors in that it appears, at least within the first year of therapy, to have only a small negative impact on lipid levels. Atazanavir is commonly used with the protease inhibitor ritonavir (Norvir), which boosts, or raises, the concentration of atazanavir in the blood. However, some physicians may be tempted to prescribe unboosted atazanavir —without a small dose of ritonavir—to take advantage of atazanavir’s perceived lipid-neutral reputation. The risk of this strategy is that HIV may develop resistance to atazanavir more easily w