title: Increase in serum bilirubin in HIV/hepatitis-C virus-coinfected patients on atazanavir therapy following initiation of pegylated-interferon and ribavirin.
abstract: Atazanavir use is associated with increases in serum bilirubin. Ribavirin, used to treat hepatitis-C infection, cause hemolysis and may worsen hyperbilirubinemia. We studied HIV/hepatitis-C virus-coinfected patients who initiated hepatitis-C therapy. Hyperbilirubinemia grade 3-4 increased from 9% to 45% after the start of hepatitis-C treatment in patients who used atazanavir concomitantly. Atazanavir use and hemoglobin (Hb) drops were predictors of increases in bilirubin. A substantial proportion of patients under atazanavir-therapy experienced significant hyperbilirubinemia and jaundice following initiation of hepatitis-C therapy.
authors.affiliation: Pharmacokinetic and Pharmacogenetic Unit, Hospital Carlos III, Madrid, Spain. sonia_r_novoa@hotmail.com
authors.forename: Sonia
authors.initials: S
authors.lastname: Rodríguez-Nóvoa
authors.forename: Judit
authors.initials: J
authors.lastname: Morello
authors.forename: Mar
authors.initials: M
authors.lastname: González
authors.forename: Eugenia
authors.initials: E
authors.lastname: Vispo
authors.forename: Pablo
authors.initials: P
authors.lastname: Barreiro
authors.forename: Gema
authors.initials: G
authors.lastname: González-Pardo
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Jiménez-Nácher
authors.forename: Juan
authors.initials: J
authors.lastname: Gonzalez-Lahoz
authors.forename: Vincent
authors.initials: V
authors.lastname: Soriano
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects; D000069446:Atazanavir Sulfate; D001663:Bilirubin / Q000378:metabolism*; D004347:Drug Interactions; D005260:Female; D014453:Glucuronosyltransferase / Q000187:drug effects / Q000378:metabolism*; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000201:enzymology; D017320:HIV Protease Inhibitors / Q000009:adverse effects; D015497:HIV-1; D016174:Hepacivirus / Q000187:drug effects* / Q000201:enzymology; D006801:Humans; D006932:Hyperbilirubinemia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000009:adverse effects; D011725:Pyridines / Q000009:adverse effects; D012254:Ribavirin / Q000009:adverse effects; D000099148:UGT1A1 Enzyme
chemical_list: D000998:Antiviral Agents; D000069446:Atazanavir Sulfate; D001663:Bilirubin; D014453:Glucuronosyltransferase; D017320:HIV Protease Inhibitors; D009842:Oligopeptides; D011725:Pyridines; D012254:Ribavirin; D000099148:UGT1A1 Enzyme