RT Book, Section A1 Hibma, Jennifer E. A1 Giacomini, Kathleen M. A2 Katzung, Bertram G. A2 Vanderah, Todd W. SR Print(0) ID 1176969130 T1 Pharmacogenomics T2 Basic & Clinical Pharmacology, 15e YR 2021 FD 2021 PB McGraw-Hill PP New York, NY SN 9781260452310 LK accessmedicine.mhmedical.com/content.aspx?aid=1176969130 RD 2024/03/28 AB CASE STUDYA 35-year-old man with newly diagnosed human immunodeficiency virus (HIV) infection was prescribed an antiretroviral regimen that 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?