{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T03:40:43Z","timestamp":1767066043469},"reference-count":16,"publisher":"American Society for Microbiology","issue":"8","license":[{"start":{"date-parts":[[2013,8,1]],"date-time":"2013-08-01T00:00:00Z","timestamp":1375315200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Atazanavir (ATV) causes an elevation of unconjugated hyperbilirubinemia (HBR) as a result of UDP glucuronyltransferase (UGT) 1A1 inhibition. Zinc sulfate (ZnSO\n            <jats:sub>4<\/jats:sub>\n            ) reduces unconjugated hyperbilirubinemia in individuals with Gilbert's syndrome. We assessed the changes in total, conjugated, and unconjugated bilirubin and the effect on ATV pharmacokinetics (PK) after single and 14-day dosing of ZnSO\n            <jats:sub>4<\/jats:sub>\n            . HIV patients, stable on ATV\/ritonavir (ATV\/r)-containing regimens with a total bilirubin level of &gt;25mmol\/liter received 125 mg daily of ZnSO\n            <jats:sub>4<\/jats:sub>\n            as Solvazinc tablets for 14 days. ATV\/r and bilirubin concentrations were measured pre-ATV\/r dose and 2, 4, 6, 8, and 24 h post-ATV\/r dose; before ZnSO\n            <jats:sub>4<\/jats:sub>\n            initiation (phase 1), after a single dose (phase 2) and after 14 days (phase 3). Changes in bilirubin and ATV\/r concentrations in the absence or presence of ZnSO\n            <jats:sub>4<\/jats:sub>\n            were evaluated by geometric mean ratios (GMRs) and 90% confidence intervals (CIs; we used phase 1 as a reference). Sixteen male patients completed the study maintaining virologic suppression; ZnSO\n            <jats:sub>4<\/jats:sub>\n            was well tolerated. Statistically significant declines in total bilirubin\n            <jats:italic>C<\/jats:italic>\n            <jats:sub>max<\/jats:sub>\n            and AUC\n            <jats:sub>0\u201324<\/jats:sub>\n            of 16 and 17% were seen in phase2 and 20% in phase 3. Although there were no significant changes in conjugated bilirubin, unconjugated bilirubin\n            <jats:italic>C<\/jats:italic>\n            <jats:sub>max<\/jats:sub>\n            and AUC\n            <jats:sub>0\u201324<\/jats:sub>\n            of were lower (17 and 19%, phase 2; 20 and 23% during phase 3). The ATV GMRs (90% CI) for\n            <jats:italic>C<\/jats:italic>\n            <jats:sub>trough<\/jats:sub>\n            ,\n            <jats:italic>C<\/jats:italic>\n            <jats:sub>max<\/jats:sub>\n            , and AUC\n            <jats:sub>0\u201324<\/jats:sub>\n            were 0.74 (0.62 to 0.89), 0.82 (0.70 to 0.97), and 0.78 (0.70 to 0.88). Intake of ZnSO\n            <jats:sub>4<\/jats:sub>\n            decreases total and unconjugated bilirubin and causes modest declines in ATV exposure. ZnSO\n            <jats:sub>4<\/jats:sub>\n            supplementation may be useful in management of ATV-related HBR in selected patients.\n          <\/jats:p>","DOI":"10.1128\/aac.00357-13","type":"journal-article","created":{"date-parts":[[2013,5,21]],"date-time":"2013-05-21T05:04:18Z","timestamp":1369112658000},"page":"3640-3644","update-policy":"http:\/\/dx.doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":10,"title":["Coadministration of Atazanavir-Ritonavir and Zinc Sulfate: Impact on Hyperbilirubinemia and Pharmacokinetics"],"prefix":"10.1128","volume":"57","author":[{"given":"Graeme","family":"Moyle","sequence":"first","affiliation":[{"name":"St. Stephen's Centre, Chelsea and Westminster Hospital, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Else","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akil","family":"Jackson","sequence":"additional","affiliation":[{"name":"St. Stephen's Centre, Chelsea and Westminster Hospital, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Back","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manisha H.","family":"Yapa","sequence":"additional","affiliation":[{"name":"St. Stephen's Centre, Chelsea and Westminster Hospital, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalia","family":"Seymour","sequence":"additional","affiliation":[{"name":"St. Stephen's Centre, Chelsea and Westminster Hospital, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Ringner-Nackter","sequence":"additional","affiliation":[{"name":"St. Stephen's Centre, Chelsea and Westminster Hospital, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeenat","family":"Karolia","sequence":"additional","affiliation":[{"name":"St. Stephen's Centre, Chelsea and Westminster Hospital, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Gazzard","sequence":"additional","affiliation":[{"name":"St. Stephen's Centre, Chelsea and Westminster Hospital, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Boffito","sequence":"additional","affiliation":[{"name":"St. Stephen's Centre, Chelsea and Westminster Hospital, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","volume-title":"BHIVA guidelines for the treatment of HIV-1 positive adults with antiretroviral therapy 2012","author":"British HIV Association","year":"2012","unstructured":"British HIV Association. 2012. BHIVA guidelines for the treatment of HIV-1 positive adults with antiretroviral therapy 2012. BHIVA, London, United Kingdom."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkl379"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200363160-00003"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200969080-00009"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2011.0092"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21361"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181c990bf"},{"key":"e_1_3_2_9_2","unstructured":"London HIV Consortium. 2011. Improving the cost of ARVs in London: summary of ARV prescribing messages for London. London HIV Consortium London United Kingdom. www.londonspecializedcommissioning.nhs.uk."},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1665-2681(19)32191-X"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.111990"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/114.5.813"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1309\/V6GVYW2QTYD5C5PJ"},{"key":"e_1_3_2_14_2","first-page":"1455","article-title":"Validation of a rapid and sensitive high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS\/MS) assay for the simultaneous determination of existing and new antiretroviral compounds","volume":"878","author":"Else LL","year":"2010","unstructured":"ElseLL WatsonVV TjiaJJ HughesAA SiccardiMM KhooSS BackDD. 2010. Validation of a rapid and sensitive high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS\/MS) assay for the simultaneous determination of existing and new antiretroviral compounds. CORD Conf. Proc. 878:1455\u20131465.","journal-title":"CORD Conf. Proc"},{"key":"e_1_3_2_15_2","first-page":"14","article-title":"Updated guideline to perform therapeutic drug monitoring for antiretroviral agents","volume":"4","author":"Porte CJ","year":"2006","unstructured":"PorteCJ BackD BlaschkeT BoucherCA FletcherCV FlexnerC GerberJ KashubaAD SchapiroJM BurgerDM. 2006. Updated guideline to perform therapeutic drug monitoring for antiretroviral agents. Rev. Antivir. 4:14.","journal-title":"Rev. Antivir"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840040807"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.33.11.1841"}],"container-title":["Antimicrobial Agents and Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.00357-13","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.00357-13","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T22:32:15Z","timestamp":1645482735000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/AAC.00357-13"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,8]]},"references-count":16,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2013,8]]}},"alternative-id":["10.1128\/AAC.00357-13"],"URL":"https:\/\/doi.org\/10.1128\/aac.00357-13","relation":{},"ISSN":["0066-4804","1098-6596"],"issn-type":[{"value":"0066-4804","type":"print"},{"value":"1098-6596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,8]]},"assertion":[{"value":"2013-02-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-05-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-07-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}