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HIV Meds Quarterly
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Spring 2008 issue
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Research Briefs
Raltegravir Substitution for Enfuvirtide
Data presented at CROI support this increasingly common strategy.
Atazanavir: New Efficacy Data and Changes in Dosage Recommendations

Because of its once-daily dosing schedule, low pill burden, and tolerability, atazanavir is the most widely used protease inhibitor among patients initiating antiretroviral therapy in the United States. Several new studies and data analyses will guide the use of this ARV medication.

Efficacy: Atazanavir/Ritonavir vs Lopinavir/Ritonavir
Results from a study comparing boosted ATV to lopinavir/ritonavir in ARV naive patients.
Concurrent Use of Atazanavir and Acid-Lowering Medications
Dosing strategies and available evidence are discussed.
Atazanavir Use in Severe Renal Impairment and Renal Failure
Study of drug levels and clearance in patients on HD yields unanticipated results.
HLA-B*5701 Screening for Abacavir Hypersensitivity
Recent studies show that screening for HLA-B*5701 and avoiding abacavir in patients with the HLA-B*5701 allele substantially decreases (or perhaps eliminates) the risk of true abacavir HSR.
Reference Table
Etravirine-ARV Interactions
Reference table to help clinicians navigate the complexities of drug interactions with this new NNRTI.
Fast Takes
Darunavir: New formulation

A 600 mg tablet formulation of darunavir (Prezista) was approved by the FDA in February 2008 and should be available soon. This formulation will reduce pill burden for patients who take darunavir. The usual dosage of darunavir is 600 mg twice daily, with ritonavir 100 mg twice daily. The 300 mg formulation will continue to be available.
more on darunavir

Lamivudine: Pediatric formulation

A new pediatric formulation of lamivudine (Epivir, 3TC) was approved by the FDA in February 2008 and should be available soon. It is a 150 mg scored tablet and is intended for use by pediatric patients who can swallow pills reliably. An oral suspension is already available for pediatric patients who cannot swallow tablets. Clinicians should consult the Epivir product label for dosage recommendations.
more on lamivudine

Lopinavir/ritonavir: Pediatric formulation

A pediatric tablet formulation of lopinavir/ritonavir (Kaletra) was approved by the FDA in November 2007 and is now available in pharmacies. It contains 100 mg of lopinavir and 25 mg of ritonavir, half the strength of the adult tablet formulation. Clinicians should consult the Kaletra product label for dosage recommendations.
more on lopinavir/ritonavir

Amprenavir: Discontinued

Production of amprenavir (Agenerase) was discontinued by the U.S. manufacturer in November 2007, and this drug will no longer be available in the United States. For patients who have been taking amprenavir, clinicians should substitute fosamprenavir or another suitable ARV.
more on amprenavir

Guidelines
Updated Pediatric Antiretroviral Guidelines
Updated recommendations on timing of initial regimens, diagnostic testing in exposed infants, recently approved ARVs, and updated reference tables. February 2008.
Updated Adult and Adolescent Antiretroviral Guidelines
Updated recommendations on initial regimens, treatment interruptions, acute infection, TB coinfection. Etravirine added to reference tables. January 2008.