Long-term treatment of patients with HIV-1: the role of atazanavir

BACKGROUND: The introduction of highly-active antiretroviral therapy (HAART) remains a major milestone in the management of HIV-infected patients. Protease inhibitors (PI) are commonly used as part of triple combinations, given that to antiviral potency, better tolerance and convenience has been achieved in recent years. OBJECTIVE: To summarize and update evidence-based information about atazanavir (ATV) on initial, simplification, and rescue interventions in HIV patients. METHODS: Review of observational and randomized trials reported in medical conferences, peer-reviewed journals, and treatment guidelines. RESULTS: ATV is a second-generation PI, which has shown across studies potent antiviral activity and high genetic barrier, both in HAART-naïve patients or after virological failure. Indulgent metabolic profile, in terms of insulin glucose and lipid levels, adds value to this drug for the long-term management of HIV infection.