RT Book, Section
A1 Hibma, Jennifer E.
A1 Giacomini, Kathleen M.
A2 Katzung, Bertram G.
SR Print(0)
ID 1148433102
T1 Pharmacogenomics
T2 Basic & Clinical Pharmacology, 14e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9781259641152
LK accessmedicine.mhmedical.com/content.aspx?aid=1148433102
RD 2024/04/19
AB CASE  STUDYA  35-year-old  male  with  newly  diagnosed  human  immunodeficiency  virus  (HIV)  infection  was  prescribed  an  antiretroviral  regimen,  which  included  the  protease  inhibitor  atazanavir  300  mg  to  be  taken  by  mouth  once  daily,  along  with  ritonavir,  a  pharmacokinetic  enhancer,  and  two  nucleoside  analog  antiretroviral  agents.  Liver  function  and  renal  function  were  normal.  After  1  year  of  treatment,  the  patient  experienced  visible  yellow  discoloration  of  the  skin  and  eyes.  Blood  samples  were  drawn,  and  grade  4  hyperbilirubinemia  was  documented.  When  atazanavir  was  discontinued  and  the  antiretroviral  regimen  was  modified  to  include  lopinavir,  the  plasma  levels  of  bilirubin  returned  to  the  normal  range,  and  skin  and  eye  color  were  cleared.  Could  a  UGT1A1*28  polymorphism  have  led  to  the  adverse  effects?