Severe Hyperbilirubinemia in an HIV-HCV-Coinfected Patient Starting the 3D Regimen That Resolved After TDM-Guided Atazanavir Dose Reduction

Ther Drug Monit. 2016 Jun;38(3):285-7. doi: 10.1097/FTD.0000000000000293.

Abstract

The combination of ombitasvir, dasabuvir, and paritaprevir/ritonavir (considered as the 3D regimen) has proven to be associated with high sustained virologic response and optimal tolerability in hepatitis C virus-infected patients. Here, we describe an HIV-HCV-coinfected patient who experienced a grade 4 hyperbilirubinemia and a 2.5-fold increase in the atazanavir plasma trough concentrations few days after the start of 3D-based antiviral therapy who benefited from an atazanavir dose reduction guided by therapeutic drug monitoring.

Publication types

  • Case Reports

MeSH terms

  • 2-Naphthylamine
  • Anilides / administration & dosage
  • Antiviral Agents / administration & dosage*
  • Antiviral Agents / adverse effects
  • Atazanavir Sulfate / administration & dosage
  • Atazanavir Sulfate / adverse effects*
  • Atazanavir Sulfate / pharmacokinetics
  • Carbamates / administration & dosage
  • Coinfection
  • Cyclopropanes
  • Dose-Response Relationship, Drug
  • Drug Interactions
  • Drug Monitoring / methods
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • HIV Protease Inhibitors / administration & dosage
  • HIV Protease Inhibitors / adverse effects
  • HIV Protease Inhibitors / pharmacokinetics
  • Hepatitis C / complications
  • Hepatitis C / drug therapy*
  • Humans
  • Hyperbilirubinemia / chemically induced*
  • Lactams, Macrocyclic
  • Macrocyclic Compounds / administration & dosage
  • Middle Aged
  • Proline / analogs & derivatives
  • Ritonavir / administration & dosage
  • Sulfonamides / administration & dosage
  • Uracil / administration & dosage
  • Uracil / analogs & derivatives
  • Valine

Substances

  • Anilides
  • Antiviral Agents
  • Carbamates
  • Cyclopropanes
  • HIV Protease Inhibitors
  • Lactams, Macrocyclic
  • Macrocyclic Compounds
  • Sulfonamides
  • ombitasvir
  • Atazanavir Sulfate
  • Uracil
  • Proline
  • 2-Naphthylamine
  • dasabuvir
  • Valine
  • Ritonavir
  • paritaprevir