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14th Annual Conference of the British HIV Association23–25 April 2008, Belfast |
PATIENTS WITH HIV AND HEPATITIS C CO-INFECTION EXPERIENCE LESS ATAZANAVIR-INDUCED HYPERBILIRUBINAEMIA
HIV Med 2008; 9(Suppl. 1):22 (abstract no. P45)
A Cotter1, A Brown1, J Lambert2, G Sheehan1 and P Mallon2
1Mater Misericordiae University Hospital, Dublin, Ireland, 2School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
BACKGROUND: Hyperbilirubinaemia is frequently seen in patients treated with atazanavir (ATV). Although a genetic predisposition is thought to contribute, little is known of the factors that predict ATV-associated hyperbilirubinaemia in the clinical setting.
METHODS: A retrospective review of HIV-infected patients prescribed ATV between January 2004 and September 2007. Data included baseline demographics, information on HIV disease and treatment, hepatitis co-infection and liver function tests. Primary end-point was change in bilirubin concentrations to week 12 and secondary end-point was week 12 bilirubin. Univariate and multivariate logistic regression was used to determine the relationship between these endpoints and covariates.
RESULTS:Seventy nine patients were included (58% male, mean [SD] age 35 [7] years, 56% white, 27% black). Mean [SD] CD4 count was 200 [168] and log HIV RNA 4.1 [1.5]. 61% were IVDA and 60% HepC positive. Mean [SD] bilirubin increase to week 12 was 16 [16] mmol/L. Factors associated with bigger changes and higher bilirubin at week 12 included baseline ALT, GGT, Alk Phos, methadone use, history of IVDA, being white and Hep C positive. No disease parameters were associated with change in bilirubin. On multiple regression, being Hep C positive and history of IVDA were the only factors independently associated with change in and levels of bilirubin at week 12 (P<0.0001). Change in bilirubin was lower; 12 [13] mmol/L for HepC pos versus 21 [16] for HepC neg (P=0.006), 14 [17] for IVDA versus 21 [15] mmol/L for no IVDA (P=0.01).
CONCLUSIONS: Being HepC positive protects against ATV-induced byperbilirubinaemia. Further research is needed to determine the mechanism underlying this protective effect.
2008-04-23
P45
Copyright © 2008 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD