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| SHORT COMMUNICATION
|Year : 2016 | Volume
| Issue : 5 | Page : 582-585
Incidence of atazanavir- associated adverse drug reactions in second -line drugs treated south Indian HIV-1 infected patients
Dhakshinamoorthy Subashini1, Thongadi Ramesh Dinesha1, Jayaseelan Boobalan1, Lawrence Christopher Samuel1, Selvamuthu Poongulali1, Ambrose Pradeep1, Sunil Suhas Solomon2, Suniti Solomon1, Pachamuthu Balakrishnan1, Shanmugam Saravanan1
1 Y.R. Gaitonde Centre for AIDS Research and Education, Voluntary Health Services Hospital, Chennai, Tamil Nadu, India
2 Y.R. Gaitonde Centre for AIDS Research and Education, Voluntary Health Services Hospital, Chennai, Tamil Nadu, India; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
Background: Ritonavir-boosted atazanavir (ATV/r) is the preferred second-line protease inhibitor (PI) option for HIV patients in resource-limited settings; its pattern of adverse drug reactions (ADRs) has not been much reported from India; hence, in this study, we have analyzed the incidence of ATV/r-associated ADRs in Southern Indian HIV-1-infected patients.
Methods: In this prospective study, 111 HIV patients treated with ATV/r were included with at least 2 years follow-up visits for the emergence of hyperbilirubinemia, hypertransaminasemia, and serum creatinine elevation. The causality assessment was done based on the WHO scale for the causality assessment of suspected ADR.
Results: The incidence of severe hyperbilirubinemia, hypertransaminasemia, and creatinine elevation was 28.6, 0.76, and 1.62 cases/100 person years, respectively. 3TC/FTC + TDF (odds ratio [OR]: 6.07, confidence interval [CI]: 1.31-27.98, P = 0.015) nucleos (t) ide reverse transcriptase inhibitor backbone and male sex (OR: 18.64, CI: 2.13-162.93, P = 0.0082) were found to be significantly associated with hypertransaminasemia and creatinine elevation, respectively. The causality assessment of ADR was "possible" for all the participants. Kaplan-Meier analysis showed hyperbilirubinemia to emerge earlier (mean duration: 32.18 months, CI: 24.9-39.4 months) followed by hypertransaminasemia and creatinine elevation. Hyperbilirubinemia is an expected side effect associated with ATV/r which is benign, transient, and does not predispose to hypertransaminasemia.
Conclusion: Our study results show that patients starting ATV/r should be counseled for a good adherence in spite of the emergence of hyperbilirubinemia which generally reverts to normal range.
Dr. Shanmugam Saravanan
Y.R. Gaitonde Centre for AIDS Research and Education, Voluntary Health Services Hospital, Chennai, Tamil Nadu
Source of Support: None, Conflict of Interest: None
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