Increase in serum bilirubin in HIV/hepatitis-C virus-coinfected patients on atazanavir therapy following initiation of pegylated-interferon and ribavirin.
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.
Rodríguez-Nóvoa
Sonia
S
Pharmacokinetic and Pharmacogenetic Unit, Hospital Carlos III, Madrid, Spain. sonia_r_novoa@hotmail.com
Morello
Judit
J
González
Mar
M
Vispo
Eugenia
E
Barreiro
Pablo
P
González-Pardo
Gema
G
Jiménez-Nácher
Inmaculada
I
Gonzalez-Lahoz
Juan
J
Soriano
Vincent
V
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
D000998:Antiviral Agents; D000069446:Atazanavir Sulfate; D001663:Bilirubin; D014453:Glucuronosyltransferase; D017320:HIV Protease Inhibitors; D009842:Oligopeptides; D011725:Pyridines; D012254:Ribavirin; D000099148:UGT1A1 Enzyme