Question

Is bilirubin of 46 mmol/L on atazanavir damaging my liver?

17 January 2008. Related: All topics, Other tests, Side effects.

My lab results seems to surprise and confuse me everytime l go to see my consultant.

Last time my bilirubin was 42mmol, now it is 46mmols/L, and my doctor is adament that it is not significant to liver damage.

My combination is Reyataz (atazanavir) boosted by Norvir (ritonavir), and Kivexa (abacavir+3TC), all taken once daily.

Answer

Answer: Simon Collins

Your doctor is giving you good information.

Although the normal range for total bilirubin is from 3 to 17 mmol/L and may vary between different labs, in people using atazanavir, unless it reaches 5 x the upper limit of normal (ie 5 x 17) – approximately 60-70 mmol/L – there is no need to change doses or treatment.

There are two type of bilirubin. Unconjugated bilirubin (which is increased by atazanavir) are levels before bilirubin has been processed by the liver, and low level increases are not causing your body any damage.

For more information see this section of the side effect guide.