The natural history of leukocyturia associated with indinavir treatment in HIV+ individuals.
Urinary complications observed during indinavir treatment of HIV disease are often attributed to indinavir crystalluria. In a prospective study of urinalysis during the first year of indinavir therapy, 5 of 54 asymptomatic HIV+ individuals presented severe leukocyturia (> or =100 cells/HPF) usually accompanying indinavir crystalluria. The clinical course of these 5 individuals, successfully treated for HIV and monitored for an second follow-up year, suggests that recurrence of severe leukocyturia may be an indicator of renal damage, likely tubulointerstitial disease caused by indinavir crystalluria. This is in contrast to the remaining 49 subjects, including those presenting mild leukocyturia, who did not demonstrate any evidence of renal disease. Regular urinalysis is therefore recommended in the clinical management of indinavir-treated individuals to detect early renal damage secondary to indinavir crystalluria and to prevent further renal impairment.
Gagnon
R F
RF
Department of Medicine, The Montreal General Hospital, Montreal, Que., Canada. raymonde.gagnon@muhc.mcgill.ca
Tecimer
S N
SN
Watters
A K
AK
Hatzakis
G E
GE
Tsoukas
C M
CM
D000328:Adult; D003460:Crystallization; D004359:Drug Therapy, Combination; D005260:Female; D017320:HIV Protease Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D006679:HIV Seropositivity / Q000188:drug therapy* / Q000652:urine*; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D019469:Indinavir / Q000008:administration & dosage / Q000009:adverse effects*; D007962:Leukocytes / Q000187:drug effects*; D007964:Leukocytosis / Q000139:chemically induced* / Q000652:urine; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D013997:Time Factors; D014556:Urine / Q000166:cytology*
D017320:HIV Protease Inhibitors; D019469:Indinavir