J Korean Med Sci.  2010 Oct;25(10):1427-1430. 10.3346/jkms.2010.25.10.1427.

Incidence of Atazanavir-associated Hyperbilirubinemia in Korean HIV Patients: 30 Months Follow-up Results in a Population with Low UDP-glucuronosyltransferase1A1*28 Allele Frequency

• Choe PG
• Park WB
• Song JS
• Kim NH
• Song KH
• Park SW
• Kim HB
• Kim NJ
• Oh MD

• KMID: 2157844
• DOI: http://doi.org/10.3346/jkms.2010.25.10.1427

Abstract

Hyperbilirubinemia is frequently observed in Caucasian HIV patients treated with atazanavir. UDP-glucuronosyltransferase 1A1 polymorphism, UGT1A1*28, which is associated with atazanavir-induced hyperbilirubinemia, is less common in Asians than in Caucasians. However, little is known about the incidence of atazanavir-associated hyperbilirubinemia in Asian populations. Our objective was to investigate the incidence of and tolerability of atazanavir-associated hyperbilirubinemia in Korean HIV patients. The prevalence and cumulative incidence of atazanavir-associated hyperbilirubinemia and UGT1A1*28 allele frequency was investigated in 190 Korean HIV-infected patients treated with atazanavir 400 mg per day. The UGT1A1*28 were examined by direct sequencing of DNA from peripheral whole blood. The UGT1A1*28 allele frequency was 11%. The cumulative incidence of any grade of hyperbilirubinemia was 77%, 89%, 98%, and 100%, at 3, 12, 24, and 30 months, respectively. The cumulative incidence of severe (grade 3-4) hyperbilirubinemia was 21%, 41%, 66%, and 75%, at 3, 12, 24, and 30 months, respectively. However, the point prevalence of severe hyperbilirubinemia did not increase with time and remained around 25%. Our data suggest that atazanavir-associated hyperbilirubinemia is common but transient in a population with low UGT1A1*28 allele frequency.

Keyword

HIV; Acquired Immunodeficiency Syndrome; Atazanavir; Hyperbilirubinemia; Jaundice

MeSH Terms

Adult
Alleles
Anti-HIV Agents/*adverse effects/therapeutic use
Asian Continental Ancestry Group/*genetics
Female
Follow-Up Studies
Gene Frequency
Glucuronosyltransferase/blood/*genetics
HIV Infections/complications/*drug therapy
Humans
Hyperbilirubinemia/complications/*epidemiology/genetics
Incidence
Male
Middle Aged
Oligopeptides/*adverse effects/therapeutic use
Promoter Regions, Genetic
Pyridines/*adverse effects/therapeutic use
Republic of Korea

Figure

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  Fig. 1 Prevalence and cumulative incidence of grade 3-4 hyperbilirubinemia in Koreans HIV patients taking unboosted atazanavir.

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