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최평균,박완범,송진수,김낙현,송경호,박상원,김홍빈,김남중,오명돈 대한의학회 2010 Journal of Korean medical science Vol.25 No.10
Hyperbilirubinemia is frequently observed in Caucasian HIV patients treated with atazanavir. UDP-glucuronosyltransferase 1A1 polymorphism, UGT1A1*28, which is associated with atazanavir-induced hyperbilirubinemia, is less common in Asians than in Caucasians. However, little is known about the incidence of atazanavir-associated hyperbilirubinemia in Asian populations. Our objective was to investigate the incidence of and tolerability of atazanavir-associated hyperbilirubinemia in Korean HIV patients. The prevalence and cumulative incidence of atazanavir-associated hyperbilirubinemia and UGT1A1*28 allele frequency was investigated in 190 Korean HIV-infected patients treated with atazanavir 400 mg per day. The UGT1A1*28 were examined by direct sequencing of DNA from peripheral whole blood. The UGT1A1*28 allele frequency was 11%. The cumulative incidence of any grade of hyperbilirubinemia was 77%, 89%, 98%, and 100%,at 3, 12, 24, and 30 months, respectively. The cumulative incidence of severe (grade 3–4)hyperbilirubinemia was 21%, 41%, 66%, and 75%, at 3, 12, 24, and 30 months, respectively. However, the point prevalence of severe hyperbilirubinemia did not increase with time and remained around 25%. Our data suggest that atazanavir-associated hyperbilirubinemia is common but transient in a population with low UGT1A1*28 allele frequency.
중심정맥카테터 관련 균혈증 예방을 위한 다방면적인 접근 전략
최평균,김홍빈 대한의료관련감염관리학회 2013 의료관련감염관리 Vol.18 No.2
Central lines are indispensable in hospital care. The main complication resulting from their use is central line-associated bloodstream infection (CLABSI). CLABSI is one of the most frequent healthcare-associated infections associated with high costs, morbidity, and potential lethality. Recent studies on CLABSI prevention show that a multifaceted approach to improving central line insertion and maintenance practices results in decreased CLABSI rates. The question today, then, is not ‘what to do,’ but ‘how to do it.’
국내 HIV 감염인에서 Ritonavir-boosting 요법이 황달에 의한 Atazanavir의 중단에 미치는 영향
최평균,박완범,송경호,방지환,김의석,박상원,김홍빈,김남중,오명돈,최강원 대한감염학회 2012 Infection and Chemotherapy Vol.44 No.3
Background: Data regarding differences of intolerance between a ritonavirunboosted and a ritonavir-boosted atazanavir regimen in HIV-infected Koreans is limited. Materials and Methods: A review was conducted of the incidence of severe hyperbilirubinemia (serum total bilirubin >3.1 mg/dL) and discontinuation of atazanavir in HIV-infected patients who had received an atazanavir-containing regimen at Seoul National University Hospital from 2005 to 2009. Patients with active liver disease were excluded from the study. Results: Of a total of 335 patients receiving an atazanavir-containing regimen,145 (43.3%) received treatment with a ritonavir-boosted regimen. The cumulative incidence of severe hyperbilirubinemia at three months was 40.5% in patients receiving a ritonavir-boosted atazanavir regimen and 21.4% in patients receiving an un-boosted atazanavir regimen (P<0.001). The cumulative incidence of severe hyperbilirubinemia at 12 months was 58.5% in patients receiving a ritonavirboosted regimen and 41.3% in those receiving an un-boosted regimen (P=0.008). The proportion of drug discontinuation due to jaundice during the 12-month period was 11.7% in patients receiving a ritonavir-boosted regimen and 5.3% in those receiving an un-boosted regimen (P=0.035). Conclusions: Occurrence of severe hyperbilirubinemia and discontinuation of atazanavir due to jaundice was significantly more common in HIV-infected Koreans who received a ritonavir-boosted atazanavir regimen than in those who received a ritonavir-un-boosted atazanavir regimen.
최평균,박완범,송진수,송경호,전재현,박상원,김홍빈,장기현,오명돈,최강원,김남중 대한의학회 2010 Journal of Korean medical science Vol.25 No.7
The incidence of specific intracranial parenchymal lesions of HIV-infected patients varies considerably between countries. In the Republic of Korea, the number of HIV-infected patients is increasing, but little is known regarding the spectrum of intracranial parenchymal lesions in these patients. The aim of the present study was to obtain this information. To identify HIV patients with intracranial parenchymal lesions, the electronic database of radiological reports for 1,167 HIV-infected patients, seen from 1999 to 2008 at the Seoul National University Hospital, were reviewed. Neuroradiologic studies were performed on 165 of these patients, and intracranial parenchymal lesions were detected in 40 (3.4%) of them. Thirty-seven were male, and median age was 41 yr (range, 26-61). At the time of the diagnosis of intracranial parenchymal lesions, median CD4+ lymphocyte count was 40 cells/μL (range 5-560) and in 33 (82.5%) patients, it was less than 200 cells/μL. Progressive multifocal leukoencephalopathy (12 patients) is the most frequent intracranial parenchymal lesions, followed by intracranial tuberculoma (7 patients), primary central nervous system lymphoma (7 patients), intracranial cryptococcoma (4 patients),Toxoplasma encephalitis (4 patients), and disseminated non-tuberculous mycobacterial infection (3 patients).