RESUMEN

Hyperbilirubinaemia with or without jaundice is one of the side effects of atazanavir boosted with low-dose ritonavir (ATV/rit) related to the drug plasma levels, as a result of its metabolism by UGT1A1 - uridine diphosphate-glucuronosyl transferase. Genotyping for UGT1A1*28 before initiation of antiretroviral therapy containing atazanavir may aid in identifying individuals at risk of hyperbilirubinaemia. Our objective was to estimate the prevalence of the UGTA1A1*28 polymorphism in HIV-infected individuals in Greece and to determine its potential association with hyperbilirubinaemia in patients receiving ATV/rit. The prevalence of the UGTA1A1*28 variant was estimated in 79 HIV-infected patients prior to the administration of the first-line treatment. The UGTA1A1*28 variant was detected in 46 out of 79 individuals (58.2%). Antiretroviral therapy was administered to 64/79 patients (81%). Among them, 26/64 (40.6%) received ATV/rit. Of the ATV/rit-treated patients, 14 were found to be carriers of the UGT1A1*28 variant (54%), and maximum serum bilirubin levels were significantly higher in the carrier population (4.71 vs. 2.69 mg/dL, p = 0.026). In 50% of the population, maximum levels were recorded in the first month of follow-up. Although carriage of UGT1A1 is linked with the development of hyperbilirubinaemia, the implementation of a pharmacogenomic approach in clinical practice cannot yet be recommended as a standard of care.

Asunto(s)

Fármacos Anti-VIH/administración & dosificación , Glucuronosiltransferasa/genética , Infecciones por VIH/tratamiento farmacológico , Inhibidores de la Proteasa del VIH/administración & dosificación , Hiperbilirrubinemia/genética , Oligopéptidos/administración & dosificación , Polimorfismo Genético , Piridinas/administración & dosificación , Adulto , Anciano , Fármacos Anti-VIH/efectos adversos , Terapia Antirretroviral Altamente Activa , Sulfato de Atazanavir , Bilirrubina/metabolismo , Estudios Transversales , Grecia/epidemiología , Infecciones por VIH/epidemiología , Inhibidores de la Proteasa del VIH/efectos adversos , Humanos , Hiperbilirrubinemia/inducido químicamente , Hiperbilirrubinemia/enzimología , Persona de Mediana Edad , Oligopéptidos/efectos adversos , Farmacogenética , Prevalencia , Piridinas/efectos adversos , Ritonavir/administración & dosificación

RESUMEN

UNLABELLED: The Hospital Anxiety and Depression Scale (HADS) has been translated and widely used in several countries to assess anxiety and depression in general hospital patients with good results. Material-Method The HADS was administered to 521 participants (275 controls and 246 inpatients and outpatients of Internal Medicine and Surgical Departments). The Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI) were used as "gold standards" for depression and anxiety respectively. Results The HADS presented high internal consistency; Cronbach's α=0.884 (0.829 for anxiety and 0.840 for depression) and stability (test-retest Intraclass Correlation Coefficient 0.944). Factor analysis showed a two-factor structure. The HADS showed high concurrent validity; the correlations of the scale and its subscales with the BDI and the STAI were high (0.722-0.749). CONCLUSIONS: The Greek version of HADS showed good psychometric properties and could prove as a good tool for clinicians to assess anxiety and depression in general hospital patients.