Park et al identified risk factors for severe hyperbilirubinemia in an HIV-patient receiving atazanavir therapy. These can help to identify a patient who should avoid this medication. The authors are from Seoul National University.
Subjects: HIV-positive Koreans
Severe hyperbilirubinemia was defined as either Grade 3 or 4 (>= 3.16 mg/dL).
Risk factors for severe hyperbilirubinemia:
(1) low CD4 lymphocyte count
(2) number of UDP-glucuronosyltransferase (UGT) 1A1*28 alleles
(3) one or both alleles in the multidrug resistance gene 1 (MDR1) G2677T or G2677A
• The risk associated with the CD4 count was 0.97 per 10 cell per µL increase. A count of 200 CD4 cells would be (0.97)^20 = 0.544. A count < 200 per µL will be used in the implementation.
If none of these factors were present then the risk for severe hyperbilirubinemia is extremely low.
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