Hyperbilirubinemia is a common and reversible adverse event with atazanavir (ATV). Polymorphism at the uridin-glucoronosyl-transferse 1A1 (UGT1A1) and multidrug resistance 1 (MDR1) genes may influence bilirubin and ATV plasma concentrations respectively. A linear correlation between ATV plasma concentrations (Ctrough) and bilirubin has not been shown but severe hyperbilirubinemia is more frequent with higher ATV plasma levels. As shown in our case report, therapeutic drug monitoring is useful to evaluate ATV Ctrough variability in clinical practice. However, atazanavir remains a manageable and tolerable drug.
Keywords: Atazanavir; Hyperbilirubinemia; Therapeutic drug monitoring; HIV.
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