title: The use of atazanavir in HIV-infected patients with liver cirrhosis: lack of hepatotoxicity and no significant changes in bilirubin values or model for end-stage liver disease score.
abstract: Although atazanavir is widely used in hepatitis C virus (HCV)-HIV-1 patients, little is known about its safety in advanced liver disease. We studied 34 HCV-HIV-1 patients with cirrhosis receiving atazanavir. After 551.2 patient-months of follow-up, there were no cases of serious liver toxicity or cirrhosis decompensation, and only 18.5% discontinued the drug. Despite median bilirubin level at inclusion was 1.5 mg/ml, increases in bilirubin level were mild. Model for end-stage liver disease score (MELD) increased to 1.35 points (95% confidence interval 0.13-2.6), but no patient changed their pretreatment situation after atazanavir introduction. Atazanavir is a well tolerated option in cirrhosis, and significant alterations in bilirubin or MELD were not observed.
authors.affiliation: Department of Infectious Diseases, Hospital Ramón y Cajal, Madrid, Spain. chemixx@gmail.com
authors.forename: Jose M
authors.initials: JM
authors.lastname: Rodriguez
authors.forename: Jose M
authors.initials: JM
authors.lastname: Hermida
authors.forename: Jose L
authors.initials: JL
authors.lastname: Casado
authors.forename: Carmen
authors.initials: C
authors.lastname: Quereda
authors.forename: Ana
authors.initials: A
authors.lastname: Moreno
authors.forename: Fernando
authors.initials: F
authors.lastname: Dronda
authors.forename: Beatriz
authors.initials: B
authors.lastname: Hernandez-Novoa
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Rodriguez
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Perez-Elias
authors.forename: Santiago
authors.initials: S
authors.lastname: Moreno
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000069446:Atazanavir Sulfate; D001663:Bilirubin / Q000378:metabolism; D058625:End Stage Liver Disease / Q000188:drug therapy*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000188:drug therapy*; D008297:Male; D009842:Oligopeptides / Q000008:administration & dosage / Q000009:adverse effects*; D011725:Pyridines / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D019380:Anti-HIV Agents; D009842:Oligopeptides; D011725:Pyridines; D000069446:Atazanavir Sulfate; D001663:Bilirubin