Impact of UGT1A1 Gilbert variant on discontinuation of ritonavir-boosted atazanavir in AIDS Clinical Trials Group Study A5202.

Ribaudo HJ, Daar ES, Tierney C, Morse GD, Mollan K, Sax PE, Fischl MA, Collier AC, Haas DW, DS Clinical Trials Group
J Infect Dis. 2013 207 (3): 420-5

PMID: 23148286 · PMCID: PMC3537445 · DOI:10.1093/infdis/jis690

The UGT1A1*28 variant has been associated with hyperbilirubinemia and atazanavir discontinuation. Protocol A5202 randomly assigned human immunodeficiency virus type 1 (HIV-1)-infected patients to receive atazanavir/ritonavir (atazanavir/r) or efavirenz, with tenofovir/emtricitabine or abacavir/lamivudine. A total of 646 atazanavir/r recipients were evaluable for UGT1A1. Homozygosity for *28/*28 was present in 8% of whites, 24% of blacks, and 18% of Hispanics and was associated with increased bilirubin concentrations. There was an association between *28/*28 and increased atazanavir/r discontinuation among Hispanic participants (P = .005) but not among white or black participants (P = .79 and P = .46, respectively). The positive predictive value of 28*/28* for atazanavir/r discontinuation among Hispanic participants was only 32% (95% confidence interval, 16%-52%).

MeSH Terms (14)

Anti-HIV Agents Antiretroviral Therapy, Highly Active Atazanavir Sulfate Bilirubin Genetic Variation Genotype Glucuronosyltransferase HIV-1 HIV Infections Humans Jaundice Oligopeptides Pyridines Ritonavir

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