Progression of Kaposi sarcoma associated with iatrogenic Cushing syndrome in a person with HIV/AIDS.
This case report describes an exacerbation of AIDS-associated Kaposi sarcoma (KS) in the setting of iatrogenic Cushing syndrome caused by an interaction between ritonavir-boosted atazanavir and fluticasone. Discontinuation of fluticasone resulted in resolution of the cutaneous KS. Clinicians should be aware of this potential drug-drug interaction that can result in increased corticosteroid levels. Inhaled corticosteroids should be used cautiously in persons with HIV/AIDS who have a history of KS and are being treated with a boosted atazanavir regimen because this can potentially exacerbate KS.
Jinno
Sadao
S
Department of Medicine, University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii, USA.
Goshima
Cyril
C
D000730:Androstadienes / Q000009:adverse effects*; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D000069446:Atazanavir Sulfate; D003480:Cushing Syndrome / Q000150:complications / Q000188:drug therapy; D004347:Drug Interactions; D000068298:Fluticasone; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D017320:HIV Protease Inhibitors / Q000009:adverse effects*; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000009:adverse effects; D011725:Pyridines / Q000009:adverse effects; D019438:Ritonavir / Q000009:adverse effects; D012514:Sarcoma, Kaposi / Q000503:physiopathology*
D000730:Androstadienes; D000893:Anti-Inflammatory Agents; D017320:HIV Protease Inhibitors; D009842:Oligopeptides; D011725:Pyridines; D000069446:Atazanavir Sulfate; D000068298:Fluticasone; D019438:Ritonavir