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Antiretroviral regimens that include protease inhibitors (PIs) typically also incorporate a pharmacologic booster to enhance plasma levels of the PI. Ritonavir is the agent most commonly used for this purpose, but the investigational booster cobicistat has several potential advantages, including more-specific CYP3A4 blockade (resulting in fewer drug interactions), a complete lack of antiretroviral activity, and fewer metabolic side effects.
In this industry-sponsored, phase II trial, 79 treatment-naive HIV-infected patients were randomized to receive tenofovir/FTC + atazanavir + either cobicistat or ritonavir. At 48 weeks, the two groups had similar proportions of patients achieving viral loads <50 copies/mL (82% in the cobicistat group and …