I have been on 300 mg Reyataz, 100 mg Norvir, and truvada for almost 4 years and it has worked great for me and with minimal side effects. My bilirubin shot up, but I realize that was a side effect and wasn't worried.

Now my bilirubin has started going between 5 and 6 consistently and my doctor wants to tweak my regimine. Ultrasound-perfectly normal. LFTs-normal. The only thing wacky is the bilirubin and a slight elevation of ALP. There is some yellowness, but it is so small it is workable--the only way someone would notice is if I purposely pointed out that my eyes had a yellow tint.

1. Did I misunderstand when I thought the bilirubin wasn't harmful?

2. Do I really need to tweak the regimine as my doc wants to and potentially mess with success and possibly not be so lucky in the side effects department?

Any opinions very much welcomed. Thank you very much.

Kim

Hi Kim,

It is terrific that you have done so well on your regimen. With regards to the bilirubin you are corret that in general isolated elevation when using atazanvir is not thought to be a reason for concern. It is important that the elevation is primarily in the "indirect" or "unconjugated" form of bilirubin, but if this is true the main problem is the cosmetic one you allude to.

I would discuss this further with your primary provider and directly ask her/him if they have any other concerns. Best, Eric