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This therapeutic combination regimen consists of tenofovir, atazanavir, and ritonavir and was specifically evaluated by the National Institute of Allergy and Infectious Diseases (NIAID) through the IMPAACT Network. The regimen is used for the treatment of HIV-1 infection and was studied in the Phase IV IMPAACT P1026s protocol to assess its pharmacokinetic properties in pregnant and postpartum women, including those co-infected with tuberculosis. Tenofovir acts as a nucleotide reverse transcriptase inhibitor (NRTI), while atazanavir is a protease inhibitor (PI). Ritonavir, also a protease inhibitor, is primarily utilized in this combination as a pharmacokinetic booster to increase the plasma levels of atazanavir by inhibiting the Cytochrome P450 3A4 (CYP3A4) enzyme. The study investigated standard and increased dosing strategies during the third trimester of pregnancy to ensure therapeutic efficacy.
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