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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Mellow Yellow
May 6, 2004

Hi There,

Most of the posts I've seen in this section say that the increased bilirubin levels caused by atazanavir are purely cosmetic and so shouldn't be of concern.

However, such costmetic 'markers' are a major concern for me. Yellowing skin and eyes are not something I want to live with from a quality of life perspective.

Is there really nothing that can be done to prevent this, apart from drinking plenty of water(?).

Thanks, Sean

Response from Dr. Henry

Only about 5% of patients on atazanavir develop bilirubin levels high enough to cause noticeable jaundice. In most of those cases in my own patients I have switched the patient to another drug. Several patients have tried to stay well hydrated and put up with it--that has been their choice. The vast majority of patients don't develop a level of indirect bilirubin that is high enough to be noticeable. As you mention, so far there has been no actual damage associated with the "yellows" but for the unlucky few they reasonably opt to use a different drug. I am not aware of any intervention that can consistently decrease the bilirubin levels in those patients (the 5% with the noticeable problem).KH

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