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Atazanavir + ritonavir + 2 NRTIs is a combination antiretroviral therapy (ART) regimen used for the treatment of HIV-1 infection. Atazanavir is a protease inhibitor that prevents viral replication by inhibiting the HIV-1 protease enzyme, which is essential for the maturation of infectious virus particles. Ritonavir acts as a pharmacokinetic booster by inhibiting cytochrome P450 3A4 (CYP3A4), thereby increasing plasma concentrations and efficacy of atazanavir. The two nucleoside reverse transcriptase inhibitors (NRTIs) in this regimen inhibit reverse transcriptase, an enzyme necessary for viral RNA to DNA conversion, further suppressing HIV replication. This combination offers potent virologic suppression, high genetic barrier to resistance, and favorable metabolic profiles compared to some other regimens. It is recommended as a preferred first-line or alternative regimen in various international guidelines for both treatment-naive and experienced patients with HIV-1 infection[1][2][5].
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