Infect Chemother.  2012 Jun;44(3):175-179. 10.3947/ic.2012.44.3.175.

Effect of Ritonavir-boosting on Atazanavir Discontinuation due to Jaundice in HIV-infected Koreans

• Choe PG
• Park WB
• Song KH
• Bang JH
• Kim ES
• Park SW
• Kim HB
• Kim NJ
• Oh MD
• Choe KW

• KMID: 2170367
• DOI: http://doi.org/10.3947/ic.2012.44.3.175

Abstract

BACKGROUND
Data regarding differences of intolerance between a ritonavir-unboosted and a ritonavir-boosted atazanavir regimen in HIV-infected Koreans is limited.
MATERIALS AND METHODS
A review was conducted of the incidence of severe hyperbilirubinemia (serum total bilirubin >3.1 mg/dL) and discontinuation of atazanavir in HIV-infected patients who had received an atazanavir-containing regimen at Seoul National University Hospital from 2005 to 2009. Patients with active liver disease were excluded from the study.
RESULTS
Of a total of 335 patients receiving an atazanavir-containing regimen, 145 (43.3%) received treatment with a ritonavir-boosted regimen. The cumulative incidence of severe hyperbilirubinemia at three months was 40.5% in patients receiving a ritonavir-boosted atazanavir regimen and 21.4% in patients receiving an un-boosted atazanavir regimen (P<0.001). The cumulative incidence of severe hyperbilirubinemia at 12 months was 58.5% in patients receiving a ritonavir-boosted regimen and 41.3% in those receiving an un-boosted regimen (P=0.008). The proportion of drug discontinuation due to jaundice during the 12-month period was 11.7% in patients receiving a ritonavir-boosted regimen and 5.3% in those receiving an un-boosted regimen (P=0.035).
CONCLUSIONS
Occurrence of severe hyperbilirubinemia and discontinuation of atazanavir due to jaundice was significantly more common in HIV-infected Koreans who received a ritonavir-boosted atazanavir regimen than in those who received a ritonavir-un-boosted atazanavir regimen.

Keyword

HIV; Atazanavir; Ritonavir; Hyperbilirubinemia; Jaundice

MeSH Terms

Atazanavir Sulfate
Bilirubin
HIV
Humans
Hyperbilirubinemia
Incidence
Jaundice
Liver Diseases
Oligopeptides
Pyridines
Ritonavir
Bilirubin
Oligopeptides
Pyridines
Ritonavir

Figure

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  Figure 1 Cumulative incidence of hyperbilirubinemia among HIV-infected Koreans receiving an atazanavir-containing regimen. (A) Any grade hyperbilirubinemia (serum total bilirubin >1.2 mg/dL), (B) severe hyperbilirubinemia (serum total bilirubin >3.1 mg/dL).

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