Introduction: Atazanavir, an anti-HIV drug, induces urinary stone formation. We herein report a case of atazanavir-induced bilateral ureteral stones treated with endourological procedures.
Case Presentation: A 47-year-old male patient on atazanavir was admitted with right flank pain. The patient's serum creatinine level was 3.60 mg/dL. Plain computed tomography showed bilateral hydronephrosis. The left upper ureter was obstructed by a 13 × 12 × 9-mm mass, which had very low CT attenuation values. The lower part of the right ureter was obstructed, but no mass was observed. Given his medical history, we suspected bilateral ureteral obstruction caused by drug-induced stones. A ureteral stent was successfully inserted on the right side, but not on the left side. Thereafter, a bilateral ureteroscopic lithotripsy was performed. Infrared spectrophotometry revealed that the stone component was atazanavir.
Conclusion: Understanding the characteristics of these rare drug-induced stones will aid in the proper early diagnosis and treatment.
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Introduction: Atazanavir, an anti-HIV drug, induces urinary stone formation. We herein report a case of atazanavir-induced bilateral ureteral stones treated with endourological procedures.
Case Presentation: A 47-year-old male patient on atazanavir was admitted with right flank pain.
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Single-nucleotide polymorphisms in the UDP-glucuronosyltransferase 1A-3' untranslated region are associated with atazanavir-induced nephrolithiasis in patients with HIV-1 infection: a pharmacogenetic study.
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AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan Center for AIDS Research, Kumamoto University, Kumamoto, Japan
Objectives: Ritonavir-boosted atazanavir (atazanavir/ritonavir) is a widely used antiretroviral drug, though it can potentially cause nephrolithiasis. The aim of this study was to determine the relationship between polymorphisms in genes encoding proteins involved in metabolism and transportation of atazanavir, and atazanavir/ritonavir-induced nephrolithiasis in HIV-1-infected patients treated with atazanavir/ritonavir.
Methods: Nineteen SNPs in the ABCB1, NR1I2, UGT1A1, SLCO1B1 and CYP3A5 genes were examined in case patients with atazanavir/ritonavir-induced nephrolithiasis (n = 31) and controls (n = 47).
Atazanavir-induced urine crystals demonstrated by infrared spectroscopic analysis.
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Departments of Informative Clinical Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.
Atazanavir sulfate, an azapeptide inhibitor of HIV protease, has been associated with urolithiasis. A 60-year-old man with atazanavir-induced urinary sediment crystals verified by infrared spectroscopic analysis is described. He had been receiving highly active antiretroviral therapy (HAART) for HIV infection and also had a history of urinary lithiasis and been undergoing urinalysis once every month.
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Department of Pharmacy, Faculty of Pharmacy, Silapakorn University, Nakornpathom, Thailand.
Atazanavir is one highly active antiretroviral therapy for naïve patients or patients with previous regimen failure. However, it seems that the protease inhibitor induces hyperlipidemia. Hyperbillirubinemia is the most common clinical adverse events but reports of cardiotoxicity due to atazanavir are scarce.
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