Atazanavir and the enzyme UGT1A1
The UGT1A1 enzyme is not involved in the metabolism of atazanavir. However, atazanavir does inhibit this enzyme. UGT1A1 is the only enzyme in the body that can make bilirubin water-soluble so that it can be excreted in bile by the liver. Bilirubin is a waste product formed during the breakdown of red blood cells and can be harmful to the body when it accumulates. Depending on your genetic predisposition for the UGT1A1 enzyme, this inhibition may increase the risk of jaundice (hyperbilirubinaemia). Individuals with two reduced-function UGT1A1 alleles have the highest risk of developing jaundice.
Information about your genetic predisposition may therefore provide grounds for extra vigilance in relation to a treatment with atazanavir.
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