title: [Biliary and kidney lithiasis during treatment with daclatasvir/sofosbuvir/ribavirin and atazanavir/ritonavir + abacavir/lamivudine in an HIV/HCV genotype 4-infected patient: a case report.]
abstract: New Direct-acting Antiviral Agents (DAA)-based anti-HCV therapies currently provide extraordinary opportunities to cure patients. Drug-drug interactions are however a real challenge during treatment. In particular, in HIV-infected patients in cART, DAA choice is limited by such interactions, which can result both in reduced efficacy and toxicity. We report the case of a HIV-infected patient on cART with atazanavir/ritonavir/abacavir/lamivudine, who presented kidney and biliary lithiasis, the latter treated with endoscopic retrograde cholangiopancreatography and endoscopic biliary sphincterotomy, after beginning anti-HCV treatment with daclatasvir/sofosbuvir/ribavirin. Hyperbilirubinemia with or without jaundice is a well known side effect of atazanavir, because of its inhibition of uridine diphosphate-glucuronosyl transferase. We speculate that in this case hyperbilirubinemia worsening was due to atazanavir/ribavirin co-administration. However, pharmacokinetic data are lacking about atazanavir/daclatasvir concomitant administration in real life setting.
authors.affiliation: Clinica di Malattie Infettive e Tropicali, Università di Brescia e ASST Spedali Civili di Brescia.
authors.forename: Andrea
authors.initials: A
authors.lastname: Vavassori
authors.affiliation: Clinica di Malattie Infettive e Tropicali, Università di Brescia e ASST Spedali Civili di Brescia.
authors.forename: Paola
authors.initials: P
authors.lastname: Lanza
authors.affiliation: Clinica di Malattie Infettive e Tropicali, Università di Brescia e ASST Spedali Civili di Brescia.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Izzo
authors.affiliation: Clinica di Malattie Infettive e Tropicali, Università di Brescia e ASST Spedali Civili di Brescia.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Casari
authors.affiliation: Clinica di Malattie Infettive e Tropicali, Università di Brescia e ASST Spedali Civili di Brescia.
authors.forename: Silvia
authors.initials: S
authors.lastname: Odolini
authors.affiliation: Clinica di Malattie Infettive e Tropicali, Università di Brescia e ASST Spedali Civili di Brescia.
authors.forename: Serena
authors.initials: S
authors.lastname: Zaltron
authors.affiliation: Clinica di Malattie Infettive e Tropicali, Università di Brescia e ASST Spedali Civili di Brescia.
authors.forename: Elena
authors.initials: E
authors.lastname: Festa
authors.affiliation: Clinica di Malattie Infettive e Tropicali, Università di Brescia e ASST Spedali Civili di Brescia.
authors.forename: Francesco
authors.initials: F
authors.lastname: Castelli
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000069446:Atazanavir Sulfate / Q000008:administration & dosage; D001660:Biliary Tract Diseases / Q000139:chemically induced / Q000473:pathology / Q000628:therapy; D002219:Carbamates; D060085:Coinfection; D015224:Dideoxynucleosides / Q000008:administration & dosage; D004338:Drug Combinations; D004347:Drug Interactions; D005838:Genotype; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage; D007669:Kidney Calculi / Q000139:chemically induced / Q000473:pathology / Q000628:therapy; D019259:Lamivudine / Q000008:administration & dosage; D020347:Lithiasis / Q000139:chemically induced* / Q000473:pathology / Q000628:therapy; D008297:Male; D011759:Pyrrolidines; D012254:Ribavirin / Q000008:administration & dosage; D019438:Ritonavir / Q000008:administration & dosage; D000069474:Sofosbuvir / Q000008:administration & dosage; D014633:Valine / Q000031:analogs & derivatives; D000099227:Abacavir
chemical_list: D019380:Anti-HIV Agents; D000998:Antiviral Agents; D000069446:Atazanavir Sulfate; D002219:Carbamates; D015224:Dideoxynucleosides; D004338:Drug Combinations; D007093:Imidazoles; D019259:Lamivudine; D011759:Pyrrolidines; D012254:Ribavirin; D019438:Ritonavir; D000069474:Sofosbuvir; D014633:Valine; C492871:abacavir, lamivudine drug combination; D000099227:Abacavir; C549273:daclatasvir