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KMID : 1144320120440030175
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감염과 화학요법
2012 Volume.44 No. 3 p.175 ~ p.179
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Effect of Ritonavir-boosting on Atazanavir Discontinuation due to Jaundice in HIV-infected Koreans
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Choe Pyeong-Gyun
Park Wan-Beom
Song Kyoung-Ho
Bang Ji-Hwan
Kim Ui-Seok
Park Sang-Won
Kim Hong-Bin
Kim Nam-Joong
Oh Myoung-Don
Choe Kang-Won
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Abstract
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Background: Data regarding differences of intolerance between a ritonavirunboosted 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 ritonavirboosted 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.
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KEYWORD
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HIV, Atazanavir, Ritonavir, Hyperbilirubinemia, Jaundice
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