title: Incidence of atazanavir-associated hyperbilirubinemia in Korean HIV patients: 30 months follow-up results in a population with low UDP-glucuronosyltransferase1A1*28 allele frequency.
abstract: Hyperbilirubinemia is frequently observed in Caucasian HIV patients treated with atazanavir. UDP-glucuronosyltransferase 1A1 polymorphism, UGT1A1*28, which is associated with atazanavir-induced hyperbilirubinemia, is less common in Asians than in Caucasians. However, little is known about the incidence of atazanavir-associated hyperbilirubinemia in Asian populations. Our objective was to investigate the incidence of and tolerability of atazanavir-associated hyperbilirubinemia in Korean HIV patients. The prevalence and cumulative incidence of atazanavir-associated hyperbilirubinemia and UGT1A1*28 allele frequency was investigated in 190 Korean HIV-infected patients treated with atazanavir 400 mg per day. The UGT1A1*28 were examined by direct sequencing of DNA from peripheral whole blood. The UGT1A1*28 allele frequency was 11%. The cumulative incidence of any grade of hyperbilirubinemia was 77%, 89%, 98%, and 100%, at 3, 12, 24, and 30 months, respectively. The cumulative incidence of severe (grade 3-4) hyperbilirubinemia was 21%, 41%, 66%, and 75%, at 3, 12, 24, and 30 months, respectively. However, the point prevalence of severe hyperbilirubinemia did not increase with time and remained around 25%. Our data suggest that atazanavir-associated hyperbilirubinemia is common but transient in a population with low UGT1A1*28 allele frequency.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Pyoeng Gyun
authors.initials: PG
authors.lastname: Choe
authors.forename: Wan Beom
authors.initials: WB
authors.lastname: Park
authors.forename: Jin Su
authors.initials: JS
authors.lastname: Song
authors.forename: Nak-Hyun
authors.initials: NH
authors.lastname: Kim
authors.forename: Kyoung-Ho
authors.initials: KH
authors.lastname: Song
authors.forename: Sang Won
authors.initials: SW
authors.lastname: Park
authors.forename: Hong Bin
authors.initials: HB
authors.lastname: Kim
authors.forename: Nam Joong
authors.initials: NJ
authors.lastname: Kim
authors.forename: Myoung-don
authors.initials: MD
authors.lastname: Oh
mesh_terms: D000328:Adult; D000483:Alleles; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D044466:Asian People / Q000235:genetics*; D000069446:Atazanavir Sulfate; D005260:Female; D005500:Follow-Up Studies; D005787:Gene Frequency; D014453:Glucuronosyltransferase / Q000097:blood / Q000235:genetics*; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D006932:Hyperbilirubinemia / Q000150:complications / Q000453:epidemiology* / Q000235:genetics; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000009:adverse effects* / Q000627:therapeutic use; D011401:Promoter Regions, Genetic; D011725:Pyridines / Q000009:adverse effects* / Q000627:therapeutic use; D056910:Republic of Korea; D000099148:UGT1A1 Enzyme
chemical_list: D019380:Anti-HIV Agents; D000069446:Atazanavir Sulfate; D014453:Glucuronosyltransferase; D009842:Oligopeptides; D011725:Pyridines; D000099148:UGT1A1 Enzyme