Is ritonavir boosting associated with gout?
Asymptomatic hyperuricaemia is associated with ritonavir therapy, but gout has rarely been reported. We present a retrospective cohort study of 1825 HIV-positive patients seen at one inner London HIV clinic over a two-year period. In all, 18 patients had gout, of whom 15 were receiving antiretroviral therapy. Seven had predisposing risk factors for gout (e.g. pyrazinamide therapy, haematological malignancy). Of the remaining 11 patients, two were on no medication and eight (73%) were receiving ritonavir as a boosted protease inhibitor (PI). By comparison, 11% of HIV-positive patients without gout were receiving ritonavir (odds ratio = 22; confidence interval = 5-104). Seven of the 18 patients had documented features of lipodystrophy and dyslipidaemia. Gout was seen in patients with known risk factors for gout or who were receiving ritonavir as a boosted PI and who also had lipodystrophy.
Creighton
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S
Department of Genitourinary Medicine, Camden Primary Care Trust, Mortimer Market Centre, Mortimer Market, off Capper Street, London WC1E 6AU, UK. creightonsarah@hotmail.com
Miller
R
R
Edwards
S
S
Copas
A
A
French
P
P
D006073:Gout / Q000139:chemically induced* / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000009:adverse effects*; D039682:HIV-Associated Lipodystrophy Syndrome / Q000175:diagnosis; D006801:Humans; D033461:Hyperuricemia / Q000175:diagnosis; D015994:Incidence; D012307:Risk Factors; D019438:Ritonavir / Q000009:adverse effects*
D017320:HIV Protease Inhibitors; D019438:Ritonavir