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Correlations between atazanavir C(trough )and hyperbilirubinemia: a case report
Alessia Uglietti1, Stefano Novati, Roberto Gulminetti
1HIV/AIDS Outpatient Clinic Infectious Disease Dept, Foundation "IRCCS Policlinico San Matteo Hospital", 27100 Pavia, Italy.
Journal of Medical Case Reports
|January 12, 2010
Summary
Hyperbilirubinemia, a side effect of atazanavir, occurred in an HIV-positive man after a ritonavir overdose. Therapeutic drug monitoring revealed high drug levels but eventual bilirubin normalization, highlighting drug tolerability.
Area of Science:
- Pharmacology
- Infectious Diseases
- Toxicology
Background:
- Hyperbilirubinemia is a known side effect of atazanavir, an antiretroviral medication.
- This condition is typically reversible upon treatment cessation.
Purpose of the Study:
- To investigate hyperbilirubinemia in an HIV-positive patient experiencing an overdose of ritonavir-boosted atazanavir.
- To assess the role of therapeutic drug monitoring in managing such cases.
Main Methods:
- Case study of a 49-year-old Hispanic man with HIV.
- Utilized therapeutic drug monitoring to track atazanavir and bilirubin levels.
- Analyzed the impact of a ritonavir overdose on drug concentrations and bilirubinemia.
Main Results:
- An overdose of ritonavir led to elevated atazanavir plasma concentrations (C(trough)).
- Initial hyperbilirubinemia was observed, followed by a decrease in bilirubin levels.
- Atazanavir plasma concentrations remained high, suggesting good drug tolerability despite elevated levels.
Conclusions:
- The case highlights the occurrence of hyperbilirubinemia in an HIV-positive patient on antiretroviral therapy.
- Emphasizes the importance of therapeutic drug monitoring for investigating hyperbilirubinemia in patients on antiretroviral agents.
- The patient's tolerance of high atazanavir levels supports the drug's favorable tolerability profile.
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