The use of atazanavir in HIV-infected patients with liver cirrhosis: lack of hepatotoxicity and no significant changes in bilirubin values or model for end-stage liver disease score

AIDS. 2011 Apr 24;25(7):1006-9. doi: 10.1097/QAD.0b013e3283466f85.


Although atazanavir is widely used in hepatitis C virus (HCV)-HIV-1 patients, little is known about its safety in advanced liver disease. We studied 34 HCV-HIV-1 patients with cirrhosis receiving atazanavir. After 551.2 patient-months of follow-up, there were no cases of serious liver toxicity or cirrhosis decompensation, and only 18.5% discontinued the drug. Despite median bilirubin level at inclusion was 1.5 mg/ml, increases in bilirubin level were mild. Model for end-stage liver disease score (MELD) increased to 1.35 points (95% confidence interval 0.13-2.6), but no patient changed their pretreatment situation after atazanavir introduction. Atazanavir is a well tolerated option in cirrhosis, and significant alterations in bilirubin or MELD were not observed.

MeSH terms

  • Adult
  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / adverse effects*
  • Atazanavir Sulfate
  • Bilirubin / metabolism
  • End Stage Liver Disease / drug therapy*
  • Female
  • HIV Infections / complications*
  • HIV-1*
  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / drug therapy*
  • Male
  • Oligopeptides / administration & dosage
  • Oligopeptides / adverse effects*
  • Pyridines / administration & dosage
  • Pyridines / adverse effects*


  • Anti-HIV Agents
  • Oligopeptides
  • Pyridines
  • Atazanavir Sulfate
  • Bilirubin