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Renal stones associated with ritonavir-boosted atazanavir
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SAN FRANCISCO — There was a high incidence of renal stones among patients receiving ritonavir-boosted atazanavir compared with other protease inhibitors, researchers said here.
Presenting at the 52nd Interscience Conference on Antimicrobial Agents and Chemotherapy, Yohei Hamada, MD, of the AIDS Clinical Center of the National Center for Global Health and Medicine in Tokyo, said switching to other ART is warranted in patients who develop renal stones.
Yohei Hamada
“Since ritonavir-boosted atazanavir use is associated with an increased risk of renal stones, which is a known risk factor for chronic kidney diseases, this treatment should be carefully used in patients with concomitant kidney diseases,” Hamada told Infectious Disease News. “In addition, discontinuation of the treatment should be considered in patients who develop renal stones because the recurrence rate is high.”
Hamada and colleagues compared the incidence of renal stones in patients receiving ritonavir-boosted atazanavir with those receiving other protease inhibitors. Among 465 patients receiving ritonavir-boosted atazanavir, 31 patients developed renal stones compared with four of 775 patients receiving other protease inhibitors. After stratifying for other baseline variables, ritonavir-boosted atazanavir treatment remained a significant risk factor for renal stones.
Among the 31 patients who developed renal stones on the ritonavir-boosted atazanavir treatment, the median time from the start of treatment to diagnosis of renal stones was 24.5 months. Eighteen of these patients continued on the treatment; six of them experienced recurrence. No patient who discontinued treatment experienced a renal stone recurrence.
“The majority of our study subjects were of East Asian origin,” Hamada said. “Thus, it will be important to investigate the association between [ritonavir-boosted atazanavir] and the development of renal stones in other populations.”
For more information:
Hamada Y. #H-888. Presented at: 52nd ICAAC; Sept. 9-12; San Francisco.
Disclosure: Hamada reports no relevant financial disclosures.