title: Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for UGT1A1 and Atazanavir Prescribing.
abstract: The antiretroviral protease inhibitor atazanavir inhibits hepatic uridine diphosphate glucuronosyltransferase (UGT) 1A1, thereby preventing the glucuronidation and elimination of bilirubin. Resultant indirect hyperbilirubinemia with jaundice can cause premature discontinuation of atazanavir. Risk for bilirubin-related discontinuation is highest among individuals who carry two UGT1A1 decreased function alleles (UGT1A1*28 or *37). We summarize published literature that supports this association and provide recommendations for atazanavir prescribing when UGT1A1 genotype is known (updates at www.pharmgkb.org).
authors.affiliation: Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
authors.forename: R S
authors.initials: RS
authors.lastname: Gammal
authors.affiliation: Individualized Medicine Program, Department of Veterinary Clinical Sciences, Washington State University College of Veterinary Medicine, Pullman, Washington, USA.
authors.forename: M H
authors.initials: MH
authors.lastname: Court
authors.affiliation: Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
authors.forename: C E
authors.initials: CE
authors.lastname: Haidar
authors.affiliation: Division of Pharmaceutical Sciences, Fairleigh Dickinson University School of Pharmacy, Florham Park, New Jersey, USA.|Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: O F
authors.initials: OF
authors.lastname: Iwuchukwu
authors.affiliation: Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
authors.forename: A H
authors.initials: AH
authors.lastname: Gaur
authors.affiliation: Department of Genetics, Stanford University, Stanford, California, USA.
authors.forename: M
authors.initials: M
authors.lastname: Alvarellos
authors.affiliation: Laval University CHU de Québec Research Center, Quebec, Quebec, Canada.
authors.forename: C
authors.initials: C
authors.lastname: Guillemette
authors.affiliation: Division of Infectious Disease, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Lennox
authors.affiliation: Department of Genetics, Stanford University, Stanford, California, USA.
authors.forename: M
authors.initials: M
authors.lastname: Whirl-Carrillo
authors.affiliation: Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
authors.forename: S S
authors.initials: SS
authors.lastname: Brummel
authors.affiliation: Center for Personalized Therapeutics, Comprehensive Cancer Center, The University of Chicago, Chicago, Illinois, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Ratain
authors.affiliation: Department of Genetics, Stanford University, Stanford, California, USA.
authors.forename: T E
authors.initials: TE
authors.lastname: Klein
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York, USA.
authors.forename: B R
authors.initials: BR
authors.lastname: Schackman
authors.affiliation: Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
authors.forename: K E
authors.initials: KE
authors.lastname: Caudle
authors.affiliation: Departments of Medicine, Pharmacology, Pathology, Microbiology & Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
authors.forename: D W
authors.initials: DW
authors.lastname: Haas
mesh_terms: D000069446:Atazanavir Sulfate / Q000009:adverse effects*; D020022:Genetic Predisposition to Disease; D005838:Genotype; D014453:Glucuronosyltransferase / Q000037:antagonists & inhibitors* / Q000235:genetics / Q000378:metabolism; D017320:HIV Protease Inhibitors / Q000009:adverse effects*; D006801:Humans; D006932:Hyperbilirubinemia / Q000139:chemically induced* / Q000201:enzymology / Q000235:genetics; D007565:Jaundice / Q000139:chemically induced* / Q000201:enzymology / Q000235:genetics; D008099:Liver / Q000187:drug effects* / Q000201:enzymology; D010597:Pharmacogenetics / Q000592:standards*; D010641:Phenotype; D018570:Risk Assessment; D012307:Risk Factors; D000099148:UGT1A1 Enzyme
chemical_list: D000069446:Atazanavir Sulfate; D014453:Glucuronosyltransferase; D017320:HIV Protease Inhibitors; D000099148:UGT1A1 Enzyme