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.
To read more or access our algorithms and calculators, please log in or register.
