Module Abstract

Management of a Patient Receiving an Initial Atazanavir/Ritonavir-Based Regimen With a Helicobacter Pylori Infection

Abstract

In this CME-certified case vignette, Ian McNicholl, PharmD, BCPS, describes the management of a 42-year-old black HIV-infected patient with statin-controlled dyslipidemia, a history of depression, and a family history of myocardial infarction. The patient begins an initial regimen of atazanavir/ritonavir 300/100 mg along with coformulated tenofovir/emtricitabine 300/200 mg, each dosed once every morning. He returns to clinic 6 months later and reports 97% adherence to his HIV medication, has an undetectable HIV-1 RNA, and has achieved an increase in CD4+ cell count to 353 cells/mm³. However, he complains of dyspepsia and heartburn with symptoms not relieved with over-the-counter antacids or ranitidine. A Helicobacter pylori antibody test is ordered and returns positive. Dr. McNicholl describes the pharmacokinetic considerations that now arise regarding management of the patient’s bacterial infection, dyslipidemia, and HIV infection.