Predictors of the change in bilirubin levels over twelve weeks of treatment with atazanavir

Hdl Handle:
http://hdl.handle.net/10147/292501
Title:
Predictors of the change in bilirubin levels over twelve weeks of treatment with atazanavir
Authors:
Cotter, Aoife G; Brown, Aisling; Sheehan, Gerard; Lambert, John; Sabin, Caroline A; Mallon, Patrick WG
Citation:
AIDS Research and Therapy. 2013 May 16;10(1):13
Issue Date:
16-May-2013
URI:
http://dx.doi.org/10.1186/1742-6405-10-13; http://hdl.handle.net/10147/292501
Abstract:
AbstractObjectiveTo determine the factors associated with change in bilirubin concentration 12 weeks after the initiation of an atazanavir (ATV)-containing antiretroviral regimen.MethodsWe performed a retrospective case note review of all patients prescribed ATV between January 2004 and October 2007 in a cohort of HIV infected subjects. Data collected included baseline demographics, hepatitis B and C serology, current antiretroviral therapy, baseline and week 12 routine bloods. The primary endpoint was the change in bilirubin concentration at 12 weeks after start of ATV. Multvariable linear regression was performed to assess the relationships between the change in bilirubin and variables of interest. Results: Eighty-three ATV-treated patients were included in the analysis of whom 46 (60.5%) were hepatitis C antibody positive. The median (interquartile range) change in bilirubin by week 12 was 16 (4, 22) umol/L; only 1 patient developed grade 4 hyperbilirubinaemia at week 12. After controlling for baseline bilirubin levels, HCV seropositivity and baseline ALP were associated with a smaller change in bilirubin over the 12 weeks with a trend towards lower increases in those receiving tenofovir. Sensitivity analyses reported similar associations with methadone use and injection drug use, when these variables replaced HCV sero-positivity in the model. Conclusion: Patients with hepatitis C co-infection experience smaller changes in bilirubin upon exposure to ATV. Although the underlying mechanism for this association remains unclear, these data support the safe use of this drug in this patient setting. Further research into the clinical predictors of ATV-related hyperbilirubinaemia is warranted.
Item Type:
Journal Article

Full metadata record

DC FieldValue Language
dc.contributor.authorCotter, Aoife G-
dc.contributor.authorBrown, Aisling-
dc.contributor.authorSheehan, Gerard-
dc.contributor.authorLambert, John-
dc.contributor.authorSabin, Caroline A-
dc.contributor.authorMallon, Patrick WG-
dc.date.accessioned2013-05-21T11:08:38Z-
dc.date.available2013-05-21T11:08:38Z-
dc.date.issued2013-05-16-
dc.identifier.citationAIDS Research and Therapy. 2013 May 16;10(1):13-
dc.identifier.urihttp://dx.doi.org/10.1186/1742-6405-10-13-
dc.identifier.urihttp://hdl.handle.net/10147/292501-
dc.description.abstractAbstractObjectiveTo determine the factors associated with change in bilirubin concentration 12 weeks after the initiation of an atazanavir (ATV)-containing antiretroviral regimen.MethodsWe performed a retrospective case note review of all patients prescribed ATV between January 2004 and October 2007 in a cohort of HIV infected subjects. Data collected included baseline demographics, hepatitis B and C serology, current antiretroviral therapy, baseline and week 12 routine bloods. The primary endpoint was the change in bilirubin concentration at 12 weeks after start of ATV. Multvariable linear regression was performed to assess the relationships between the change in bilirubin and variables of interest. Results: Eighty-three ATV-treated patients were included in the analysis of whom 46 (60.5%) were hepatitis C antibody positive. The median (interquartile range) change in bilirubin by week 12 was 16 (4, 22) umol/L; only 1 patient developed grade 4 hyperbilirubinaemia at week 12. After controlling for baseline bilirubin levels, HCV seropositivity and baseline ALP were associated with a smaller change in bilirubin over the 12 weeks with a trend towards lower increases in those receiving tenofovir. Sensitivity analyses reported similar associations with methadone use and injection drug use, when these variables replaced HCV sero-positivity in the model. Conclusion: Patients with hepatitis C co-infection experience smaller changes in bilirubin upon exposure to ATV. Although the underlying mechanism for this association remains unclear, these data support the safe use of this drug in this patient setting. Further research into the clinical predictors of ATV-related hyperbilirubinaemia is warranted.-
dc.titlePredictors of the change in bilirubin levels over twelve weeks of treatment with atazanavir-
dc.typeJournal Article-
dc.language.rfc3066en-
dc.rights.holderAoife G Cotter et al.; licensee BioMed Central Ltd.-
dc.description.statusPeer Reviewed-
dc.date.updated2013-05-20T11:04:59Z-
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