title: High prevalence of the UGT1A1*28 variant in HIV-infected individuals in Greece.
abstract: Hyperbilirubinaemia with or without jaundice is one of the side effects of atazanavir boosted with low-dose ritonavir (ATV/rit) related to the drug plasma levels, as a result of its metabolism by UGT1A1 - uridine diphosphate-glucuronosyl transferase. Genotyping for UGT1A1*28 before initiation of antiretroviral therapy containing atazanavir may aid in identifying individuals at risk of hyperbilirubinaemia. Our objective was to estimate the prevalence of the UGTA1A1*28 polymorphism in HIV-infected individuals in Greece and to determine its potential association with hyperbilirubinaemia in patients receiving ATV/rit. The prevalence of the UGTA1A1*28 variant was estimated in 79 HIV-infected patients prior to the administration of the first-line treatment. The UGTA1A1*28 variant was detected in 46 out of 79 individuals (58.2%). Antiretroviral therapy was administered to 64/79 patients (81%). Among them, 26/64 (40.6%) received ATV/rit. Of the ATV/rit-treated patients, 14 were found to be carriers of the UGT1A1*28 variant (54%), and maximum serum bilirubin levels were significantly higher in the carrier population (4.71 vs. 2.69 mg/dL, p = 0.026). In 50% of the population, maximum levels were recorded in the first month of follow-up. Although carriage of UGT1A1 is linked with the development of hyperbilirubinaemia, the implementation of a pharmacogenomic approach in clinical practice cannot yet be recommended as a standard of care.
authors: 4th Department of Internal Medicine, ATTIKON University General Hospital, Haidari Athens, Greece 2nd Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece ppanago@med.duth.gr.
authors: P
authors: P
authors: Panagopoulos
authors: Hygiene and Epidemiology Department, Medical School, University of Athens, Greece.
authors: D
authors: D
authors: Paraskevis
authors: 4th Department of Internal Medicine, ATTIKON University General Hospital, Haidari Athens, Greece.
authors: I
authors: I
authors: Katsarolis
authors: Hygiene and Epidemiology Department, Medical School, University of Athens, Greece.
authors: V
authors: V
authors: Sypsa
authors: Hygiene and Epidemiology Department, Medical School, University of Athens, Greece.
authors: M
authors: M
authors: Detsika
authors: 4th Department of Internal Medicine, ATTIKON University General Hospital, Haidari Athens, Greece.
authors: K
authors: K
authors: Protopapas
authors: 4th Department of Internal Medicine, ATTIKON University General Hospital, Haidari Athens, Greece.
authors: A
authors: A
authors: Antoniadou
authors: 4th Department of Internal Medicine, ATTIKON University General Hospital, Haidari Athens, Greece.
authors: A
authors: A
authors: Papadopoulos
authors: 4th Department of Internal Medicine, ATTIKON University General Hospital, Haidari Athens, Greece.
authors: G
authors: G
authors: Petrikkos
authors: Hygiene and Epidemiology Department, Medical School, University of Athens, Greece.
authors: A
authors: A
authors: Hatzakis
mesh_terms: D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000009:adverse effects; D023241:Antiretroviral Therapy, Highly Active; D000069446:Atazanavir Sulfate; D001663:Bilirubin / Q000378:metabolism; D003430:Cross-Sectional Studies; D014453:Glucuronosyltransferase / Q000235:genetics*; D006115:Greece / Q000453:epidemiology; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D017320:HIV Protease Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D006932:Hyperbilirubinemia / Q000139:chemically induced / Q000201:enzymology / Q000235:genetics*; D008875:Middle Aged; D009842:Oligopeptides / Q000008:administration & dosage* / Q000009:adverse effects; D010597:Pharmacogenetics; D011110:Polymorphism, Genetic; D015995:Prevalence; D011725:Pyridines / Q000008:administration & dosage* / Q000009:adverse effects; D019438:Ritonavir / Q000008:administration & dosage
chemical_list: D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D009842:Oligopeptides; D011725:Pyridines; D000069446:Atazanavir Sulfate; D014453:Glucuronosyltransferase; D019438:Ritonavir; D001663:Bilirubin
keywords: AIDS; HIV; UGT1A1; antiretroviral therapy; atazanavir; hyperbilirubinaemia; pharmacogenomics; treatment