Bibliographic record
Abstract
ABSTRACT Background: Drug interactions represent a major problem associated with highly active antiretroviral therapy. In pharmacokinetic studies, the oral absorption of atazanavir has been compromised in low pH environments. The manufacturer of this drug recommends avoiding its use with proton pump inhibitors (PPIs) and also suggests separating its administration from that of shorter-acting acid-lowering agents, such as antacids and histamine-2 receptor antagonists. Objective: To qualitatively review the evidence for drug interactions between atazanavir and acid-lowering therapies. Methods: A literature search of the following databases was conducted: EMBASE (January 1980 to June 2007), MEDLINE (January 1966 to June 2007), and PubMed (January 1949 to June 2007). All prospective or retrospective studies, case series, and case reports published in English that evaluated the interaction between acid-lowering agents and atazanavir were included. Results: Fourteen published articles fit the inclusion criteria. The results of studies of healthy adults provided evidence of an interaction between atazanavir and acid-lowering agents. However, case reports and prospective analyses in HIV-infected patients yielded conflicting results. Conclusion: Further studies are required to establish the clinical relevance of the potential interaction between PPIs and atazanavir. Until then, the concurrent use of PPIs and atazanavir should be avoided. Alternatives include switching to an antiretroviral regimen that does not include atazanavir or using shorter-acting acid-lowering agents, such as histamine-2 antagonists and antacids, with doses administered at different times from atazanavir. If the combination of PPIs and atazanavir must be used, patients should be monitored closely for viral and immunologic failure RESUME Historique : Les interactions medicamenteuses constituent un probleme majeur de la multitherapie antiretrovirale. Des etudes pharmacocinetiques ont montre que l’absorption orale de l’atazanavir etait compromise en presence d’un pH gastrique faible. Son fabricant deconseille son utilisation avec des inhibiteurs de la pompe a protons (IPP) et recommande de ne pas l’administrer simultanement avec des agents reducteurs de l’acidite gastrique d’action plus breve, comme les antiacides et les antagonistes des recepteurs H2 de l’histamine. Objectif : Evaluer qualitativement les donnees probantes sur les interactions medicamenteuses entre l’atazanavir et les agents reducteurs de l’acidite gastrique. Methodes : Une recherche bibliographique dans les bases de donnees suivantes a ete effectuee : EMBASE (de janvier 1980 a juin 2007), MEDLINE (de janvier 1966 a juin 2007) et PubMed (de janvier 1949 a juin 2007). Toutes les etudes prospectives et retrospectives, les series de cas et les observations cliniques publiees en anglais qui ont evalue les interactions entre les agents reducteurs de l’acidite gastrique et l’atazanavir ont ete incluses. Resultats : En tout, 14 articles publies ont satisfait aux criteres d’inclusion. Les resultats des etudes menees chez des adultes en bonne sante ont mis en evidence une interaction entre l’atazanavir et les agents reducteurs de l’acidite gastrique. Cependant, les observations cliniques et les analyses prospectives menees chez des patients seropositifs pour le VIH ont donne des resultats contradictoires. Conclusion : D’autres etudes sont necessaires pour etablir la preuve clinique d’une interaction potentielle entre les IPP et l’atazanavir. D’ici la, l’emploi concomitant d’IPP et d’atazanavir n’est pas recommande. Les solutions de rechange comprennent l’emploi d’une multitherapie antiretrovirale ne comportant pas d’atazanavir ou l’administration d’agents reducteurs de l’acidite gastrique d’action plus breve, comme les antagonistes des recepteurs H2 de l’histamine et les antiacides, a des heures differentes de l’atazanavir. Si on n’a d’autre choix que d’administrer des IPP et de l’atazanavir, il faut alors surveiller etroitement les patients pour l’apparition d’un echec virologique ou immunologique.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".