%0 Journal Article
%T Rhabdomyolysis in A Hiv-infected Patient Following the Addition of Raltegravir, A Case Report With Review of the Literature - Rhabdomyolysis in A Hiv-infected Patient Following the Addition of Raltegravir, A Case Report With Review of the Literature - Open Access Pub
%A Alexandria Garavaglia Wilson
%A Anna L. Johnson
%J OAP | Home | Journal of Clinical Research In HIV AIDS And Prevention | Open Access Pub
%D 2018
%X Antiretrovirals have traditionally been associated with much toxicity. Newer antiretrovirals are considered much less toxic relative to older antiretrovirals. Upon its FDA-approval in 2009, raltegravir¡¯s adverse drug reaction profile was found to be similar to placebo. However, recently there have been reports of increased creatine kinase and rhabdomyolysis following the initiation of raltegravir. We describe a 52-year-old, African-American man who developed rhabdomyolysis after starting raltegravir for HIV. Rhabdomyolysis resolved upon discontinuation of raltegravir. Use of the Naranjo adverse drug reaction probability scale indicated a probable relationship (score of 6). Although raltegravir is a well-tolerated antiretroviral, clinicians should be aware of the possibility of rhabdomyolysis when prescribing this medication. DOI10.14302/issn.2324-7339.jcrhap-13-304 The advent of highly-active antiretroviral therapy (HAART) has changed the disease course of HIV-infected patients. Mortality from HIV in the United States alone reached a peak in 1995, when 50,000 people died. Following HAART in 1995, mortality significantly decreased and has reached a plateau at approximately 10-15,000 deaths per year in the U.S.1 With relatively extended patient life-expectancies, HIV is now being treated as a chronic disease, requiring therapy that is more tolerable with less adverse effects and fewer drug interactions. Raltegravir is a relatively newer medication considered to be well-tolerated. Since 2009, raltegravir has been recommended for use as a component of HAART regimens to treat patients with HIV. In the most recent update, The Department of Health and Human Services (DHHS) guidelines state that raltegravir, when used in combination with other antiretrovirals (tenofovir/emtricitabine), is a preferred regimen for treatment-na£¿ve patients2. Raltegravir is preferred because drug interactions and adverse effects are limited compared to other antiretrovirals, making it an attractive treatment option for both treatment na£¿ve and experienced patients. However, recent reports of patients developing rhabdomyolysis with kidney damage while taking raltegravir have surfaced, raising concern. Rhabdomyolysis is characterized by the destruction of skeletal muscle cells. The classic presentation includes myalgias, elevated muscle enzymes, and tea-colored urine. A creatine kinase (CK) level at least 2-3x the upper limit of normal (ULN) is a hallmark feature of rhabdomyolysis. The serum CK may reach levels as high as 100,000 units/liter (L) (normal 44-196 units/L). The presence
%U https://www.openaccesspub.org/jcrhap/article/57