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Atazanavir Induced First Degree Atrioventricular Block and Ventricular Tachycardia: A Case Report

Wichai Santimaleeworagun PhD*, Suthiporn Pattharachayakul Pharm D**, Sarunyou Chusri MD***, Pantip Chayagul MD***

Affiliation : * Department of Pharmacy, Faculty of Pharmacy, Silapakorn University, Nakornpathom, Thailand ** Department of Clinical Pharmacy, Faculty of Pharmacy, Prince of Songkla University, Hat Yai, Songkhla, Thailand *** Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 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. The authors report a patient who had QT prolongation, first-degree atrioventricularblock, and ventricular tachycardia. After atazanavir/ritonavir discontinuation, this patient got better and had normal electrocardiography. Lopinavir/ritonavir was carefully reintroduced during hospitalization without any adverse drug reaction. Atazanavir induced cardiotoxicity has to be monitored when using protease inhibitors.

Keywords : Atazanavir, first-degree atrioventricular block, ventricular tachycardia


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