Utilidad de atazanavir en poblaciones especiales

López, Antonio Antela

doi:10.1016/S0213-005X(08)76621-7

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En el momento actual, con el tratamiento antirretroviral (TAR) se consigue prolongar la supervivencia de las personas que viven con virus de la inmunodeficiencia humana (VIH) de forma indefinida. Debido a ello, nos encontramos cada vez con mayor frecuencia con problemas específicos que anteriormente no daba tiempo a desarrollar o no tenían la importancia que ahora alcanzan, y que configuran, a poblaciones especiales de pacientes. Ejemplos de situaciones que caracterizan a estas poblaciones especiales son: la coinfección por virus de la hepatitis B y/o C, el embarazo, la lipodistrofia, el riesgo cardiovascular, la insuficiencia renal, el tratamiento de los niños y adolescentes, la atención a personas desplazadas (inmigrantes) y el tratamiento de personas que estén recibiendo tratamiento sustitutivo con metadona, entre otras. En el presente artículo revisamos el papel que puede tener atazanavir en el TAR de pacientes en las situaciones mencionadas, excepto las que ya son tratadas específicamente en otros artículos, tal como la coinfección por virus de la hepatitis B y/o C.

Palabras clave:

Atazanavir

Embarazo

Lipodistrofia

Riesgo cardiovascular

Insuficiencia renal

Niños

Inmigrantes

Metadona

ART (antiretroviral therapy) currently continues to indefinitely prolong the survival of patients who live with HIV. Due to this, we are increasingly faced with specific problems that previously did not have time to develop or did not have the importance that they have now, and which are related to the existence of special patient populations. Examples of situations that characterise these special populations are: co-infection with hepatitis virus B and/or C, pregnancy, lipodystrophy, cardiovascular risk, renal failure, treatment of children and adolescents, immigrant health care, and the management of patients receiving methadone replacement therapy, among others. In this article we review the role that Atazanavir (ATV) can play in the ART of patients in the situations mentioned, except those that are already dealt with specifically in other articles, such as co-infection by hepatitis virus B and/or C.

Key words:

Atazanavir

Pregnancy

Lipodystrophy

Cardiovascular risk

Renal failure

Children

Immigrants

Methadone

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Bibliografía

[1]

P.M. Garcia, L.A. Kalish, J. Pitt, H. Minkoff, T.C. Quinn, S.K. Burchett, et al.

Maternal levels of plasma human immunodeficiency virus type 1 RNA and the risk of perinatal transmission. Women and Infants Transmission Study Group.

N Engl J Med, 341 (1999), pp. 394-402

http://dx.doi.org/10.1056/NEJM199908053410602 | Medline

[2]

J.P. Ioannidis, E.J. Abrams, A. Ammann, M. Bulterys, J.J. Goedert, L. Gray, et al.

Perinatal transmission of human immunodeficiency virus type 1 by pregnant women with RNA virus loads < 1000 copies/ml.

J Infect Dis, 183 (2001), pp. 539-545

[3]

D. Ripamonti, D. Cattaneo, F. Maggiolo, M. Airoldi, L. Frigerio, P. Bertuletti, et al.

Atazanavir plus low-dose ritonavir in pregnancy: pharmacokinetics and placental transfer.

AIDS, 21 (2007), pp. 2409-2415

[4]

C. Ferreira, C. Floch-Tudal, F. Meier, G. Peytavin, J. Treluyer, V. Jullien, et al.

Atazanavir in pregnancy: influence on neonatal hyperbilirubinemia.

15th Conference on Retroviruses and Opportunistic Infections; february 3-6,

[5]

M. Natha, P. Hay, G. Taylor, G. Brook, L. Sarner, L. Cunningham, et al.

Atazanavir use in pregnancy: a report of 33 cases.

14th Conference on Retoviruses and Opportunistic Infections; february 25-28,

[6]

T. Eley, E. Vandeloise, M. Child, F. Conradie, C. Zorrilla, D. Josipovic, et al.

Steady state pharmacokinetics and safety of atazanavir after treatment with ATV 300 mg once-daily/ritonavir 100 mg once-daily + ZDV/3TC during the third trimester in HIV+ women.

15th Conference on Retroviruses and Opportunistic Infections; february 3-6,

[7]

DHHS Panel. Guidelines for the use of antiretroviral agents in HIV-1 infected adults and adolescents. Diciembre, 2007. Disponible en: http://AIDSinfo.nih.gov

[8]

Recomendaciones de la SPNS/GESIDA/SEGO/AEP. Recomendaciones para el seguimiento de la infección por el VIH con relación a la reproducción, el embarazo y la prevención de la transmisión vertical 2007. Disponible en: www.gesida.seimc.org.

[9]

A. Carr, K. Samaras, S. Burton, Law, J. Freund, D.J. Chisholm, et al.

A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance in patients receiving HIV protease inhibitors.

AIDS, 12 (1998), pp. F51-F58

Medline

[10]

J. Carr Millar, M. Law, D.A. Cooper.

A syndrome of lipoatrophy, lactic acidaemia and liver dysfunction associated with HIV nucleoside analogue therapy: contribution to protease inhibitor-related lipodystrophy syndrome.

AIDS, 14 (2000), pp. F25-32

Medline

[11]

T. Swainston Harrison, L.J. Scott.

Atazanavir: a review of its use in the management of HIV infection.

Drugs, 65 (2005), pp. 2309-2336

Medline

[12]

A. Nguyen, A. Calmy, V. Schiffer, E. Bernasconi, M. Battegay, M. Opravil, et al.

Lipodystrophy and weight changes: data from the Swiss HIV Cohort Study, 2000-2006.

HIV Med, 9 (2008), pp. 142-150

http://dx.doi.org/10.1111/j.1468-1293.2007.00537.x | Medline

[13]

G. Haerter, B.J. Manfras, M. Mueller, P. Kern, A. Trein.

Regression of lipodystrophy in HIV-infected patients under therapy with the new protease inhibitor atazanavir.

AIDS, 18 (2004), pp. 952-955

Medline

[14]

N. Friis-Moller, C.A. Sabin, R. Weber, A. d’Arminio Monforte, W.M. El-Sadr, P. Reiss, et al.

Combination antiretroviral therapy and the risk of myocardial infarction.

N Engl J Med, 349 (2003), pp. 1993-2003

http://dx.doi.org/10.1056/NEJMoa030218 | Medline

[15]

N. Friis-Moller, P. Reiss, C.A. Sabin, R. Weber, A. Monforte, W. El-Sadr, et al.

Class of antiretroviral drugs and the risk of myocardial infraction.

N Engl J Med, 356 (2007), pp. 1723-1735

http://dx.doi.org/10.1056/NEJMoa062744 | Medline

[16]

EACS Guidelines. Disponible en: http://www.eacs.eu.

[17]

R. Murphy, I. Sanne, P. Cahn, P. Phanuphak, L. Percival, T. Kelleher, et al.

Doseranging, randomized, clinical trial of atazanavir with lamivudine and stavudine in antiretroviral-naïve subjects: 48-week results.

AIDS, 17 (2003), pp. 2603-2614

http://dx.doi.org/10.1097/01.aids.0000096930.51231.5d | Medline

[18]

M. Johnson, B. Grinsztejn, C. Rodríguez, J. Coco, E. DeJesus, A. Lazzarin, et al.

Atazanavir plus ritonavir or saquinavir and lopinavir/ritonavir in patients experiencing multiple virological failures.

AIDS, 19 (2005), pp. 685-694

[19]

M. Johnson, B. Grinsztejn, C. Rodríguez, J. Coco, E. DeJesus, A. Lazzarin, et al.

96-week comparison of once-daily atazanavir/ritonavir and twice-daily lopinavir/ ritonavir in patients with multiple virological failures.

AIDS, 20 (2006), pp. 711-718

http://dx.doi.org/10.1097/01.aids.0000216371.76689.63 | Medline

[20]

U. Möbius, M. Lubach-Ruitman, B. Castro-Frenzel, M. Stoll, S. Esser, E. Voigt, et al.

Switching to atazanavir improves metabolic disorders in antiretroviral- experienced patients with severe hyperlipidemia.

J Acquir Immune Defic Syndr, 39 (2005), pp. 174-180

Medline

[21]

J.M. Molina, J. Andrade-Villanueva, J. Echevarria, P. Chetchotisakd, J. Corral, N. David, et al.

Eficacy and safety of once-daily Atazanavir/ritonavir compared to twice-daily Lopinavir/ritonavir, each in combination with Tenofovir and Emtricitabine in ARV-naïve HIV-1-infected subjects: the CASTLE study, 48-week results.

15th Conference on Retroviruses and Opportunistic Infections, Boston, MA, 3-6 febrero,

[22]

M.A. Noor, O.P. Flint, J.F. Maa, R.A. Parker.

Effects of atazanavir/ritonavir and lopinavir/ritonavir on glucose uptake and insulin sensitivity: demonstrable differences in vitro and clinically.

AIDS, 20 (2006), pp. 1813-1821

http://dx.doi.org/10.1097/01.aids.0000244200.11006.55 | Medline

[23]

J. Jemsek, E. Arathoon, M. Arlotti, C. Perez, N. Sosa, V. Pokrovskiy, et al.

Body fat and other metabolic effects of atazanavir and efavirenz, each administered in combination with zidovudine plus lamivudine in antiretroviral naïve HIV-infecetd patients.

Clin Infect Dis, 42 (2006), pp. 273-280

http://dx.doi.org/10.1086/498505 | Medline

[24]

S. Agarwala, T. Eley, M. Child, Y. Wang, A. Persson, D. Filoramo, et al.

Pharmacokinetics of Atazanavir in severely renally impaired subjects including those on hemodialysis.

8th International Workshop on Clinical Pharmacology of HIV Therapy,

[25]

T. Meyers, R. Rutstein, P. Samson, A. Violari, M. Palmer, J. Kiser, et al.

Treatment responses to Atazanavir-containing HAART in a drug-naïve paediatrics population in South Africa.

15th Conference on Retroviruses and Opportunistic Infections, Boston, MA, 3-6 Febrero,

[26]

ONUSIDA/07.

Situación de la epidemia de SIDA (versión española, diciembre de 2007).

OMS, (2007),

[27]

Encuesta hospitalaria de pacientes VIH/SIDA. Resultados 2006. Análisis de la evolución 1996-2006. Disponible en: http://www.msc.es/ciudadanos/enfLesiones/enfTransmisibles.htm.

[28]

Infección por VIH y SIDA en España Plan Multisectorial. Indicadores 2006. Disponible en: http://www.msc.es/ciudadanos/enfLesiones/enfTransmisibles/sida/planesEstrat/indicadores2006_3.pdf 2006.

[29]

Plan Nacional sobre Drogas. Disponible en: http://www.pnsd.msc.es

[30]

E.L. Schwartz, A.B. Brechbühl, P. Kahl, M.A. Miller, P.A. Selwyn, G.H. Friedland, et al.

Pharmacokinetic interactions of zidovudine and methadone in intravenous drug-using patients with HIV infections.

J Acquir Immune Defic Syndr, 5 (1992), pp. 619-626

[31]

S.M. Clarke, F. Mulcahy, J. Tjia, H.E. Reynolds, S.E. Gibbons, M.G. Barry, et al.

Pharmacokinetic interactions of nevirapine and methadone and guidelines for use of nevirapine to treat injection drug users.

Clin Infect Dis, 33 (2001), pp. 1595-1597

http://dx.doi.org/10.1086/322519 | Medline

[32]

S.M. Clarke, F.M. Mulcahy, J. Tjia, H.E. Reynolds, S.E. Gibbons, M.G. Barry, et al.

The pharmacokinetics of methadone in HIV-positive patients receiving the non-nucleoside reverse transcriptase inhibitor efavirenz.

Br J Clin Pharmacol, 51 (2001), pp. 213-217

Medline

[33]

R.D. Bruce, F.L. Altice, M.N. Gourevitch, G.H. Friedland.

Pharmacokinetic Drug Interactions Between Opioid Agonist Therapy and Antiretroviral Medications: Implications and Management for Clinical Practice.

J Acquir Immune Defic Syndr, 41 (2006), pp. 563-572

http://dx.doi.org/10.1097/01.qai.0000219769.89679.ec | Medline

[34]

S.M. Robertson, S.R. Penzak, A.K. Pau.

Drug interactions in the management of HIV infection: an update.

Expert Opin Pharmacother, 8 (2007), pp. 2947-2963

http://dx.doi.org/10.1517/14656566.8.17.2947 | Medline

[35]

G. Friedland, L. Andrews, T. Schreibman, S. Agarwala, L. Daley, M. Child, et al.

Lack of an effect of Atazanavir on steady-state pharmacokinetics of methadone in patients chronically treated for opiate addiction.

AIDS, 19 (2005), pp. 1635-1641

Medline

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