Trial reportBritish journal of clinical pharmacology2025
Model-based evaluation of the interaction between ritonavir-boosted atazanavir and rifampicin in Ugandan adults with HIV.
Trial report in British journal of clinical pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04121195 (A Phase 3, Open-label, Dose Escalation Study to Determine the Pharmacokinetics of Atazanavir Administered With RIfampicin to HIV Positive Adults on sEcond-line ART Regimen With Suppressed HIV-1 Viral Load), which is not on this map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Phase 3, Open-label, Dose Escalation Study to Determine the Pharmacokinetics of Atazanavir Administered With RIfampicin to HIV Positive Adults on sEcond-line ART Regimen With Suppressed HIV-1 Viral Load (DERIVE)
Who cites it
2 citing papers in PubMed.
- Model-based evaluation of the interaction between ritonavir-boosted atazanavir and rifampicin in Ugandan adults with HIV.British journal of clinical pharmacology · 2025Trial
- Population pharmacokinetics of ritonavir-boosted atazanavir in subsequent-line treatment in African children with HIV.Antimicrobial agents and chemotherapy · 2026Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
aimConcomitant treatment of tuberculosis (TB) and human immunodeficiency virus (HIV) is complicated by drug-drug interactions (DDI). This analysis aimed to characterize the DDI between ritonavir-boosted atazanavir (ATV/r) and rifampicin in plasma and peripheral blood mononuclear cells (PBMC).
methodsThe DERIVE study (NCT04121195) recruited Ugandan adults with HIV (not TB) on ATV/r-based second-line antiretroviral therapy, and collected intensive plasma and PBMC pharmacokinetic samples during four visits: (i) standard-dose ATV/r 300/100 mg QD, (ii) same ATV/r regimen adding rifampicin 600 mg QD, (iii) doubling ATV/r to BID with rifampicin 600 mg QD and (iv) ATV/r 300/100 mg BID with rifampicin increased to 1200 mg QD. ATV/r plasma and PBMC concentrations were analysed with population pharmacokinetic modelling in NONMEM.
resultsTwenty-six participants (23 female) were enrolled, with median age and weight of 44 years and 67 kg, respectively. A two-compartment model with an effect-compartment effectively described atazanavir concentrations in plasma and PBMC. Rifampicin increased atazanavir clearance threefold, while decreasing its bioavailability and absorption rate. Doubling dosing frequency of ATV/r largely mitigated the interaction with rifampicin, restoring the proportion of simulated participants achieving the targeted trough atazanavir concentration of 0.014 mg/L to 99%. Rifampicin did not affect the ratio of atazanavir concentration between PBMCs and plasma.
conclusionMetabolic induction by rifampicin accounts for the decrease in plasma exposure of ATV/r. Doubling the ATV/r dosing frequency to BID effectively mitigated this interaction. The plasma exposure of ATV/r mirrored that in PBMCs, suggesting that for these drugs, plasma concentrations provide a reliable reflection of site-of-action exposures.
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