title: Rapid onset of rhabdomyolysis after switching to a raltegravir-based antiretroviral regimen.
abstract: Raltegravir is the first integrase inhibitor antiretroviral agent that has been demonstrated to have antiviral efficacy and safety. However, the US Food and Drug Administration has recommended use with caution in patients with risk factors for rhabdomyolysis, based on four case reports of rhabdomyolysis in patients with identifiable risk factors. We present a 32-year-old Asian man with human immunodeficiency virus (HIV), but without other underlying diseases, who developed rapid-onset, raltegravir-associated rhabdomyolysis and hyperlactatemia. Our patient lacked predisposing factors for rhabdomyolysis, and the rapid onset time of 4 days was the shortest reported. Therefore, clinicians should exercise caution when using raltegravir and closely monitor all patients for the symptoms of muscle pain and weakness. This case has been reported to the National Adverse Drug Reactions Reporting System of the Department of Health in Taiwan.
authors.affiliation: Section of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Wan-Jung
authors.initials: WJ
authors.lastname: Tsai
authors.affiliation: Section of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: ssjlee28@yahoo.com.tw.
authors.forename: Susan Shin-Jung
authors.initials: SS
authors.lastname: Lee
authors.affiliation: Section of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Hung-Chin
authors.initials: HC
authors.lastname: Tsai
authors.affiliation: Section of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Cheng-Len
authors.initials: CL
authors.lastname: Sy
authors.affiliation: Section of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Jui-Kuang
authors.initials: JK
authors.lastname: Chen
authors.affiliation: Section of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Kuang-Sheng
authors.initials: KS
authors.lastname: Wu
authors.affiliation: Section of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Yung-Hsin
authors.initials: YH
authors.lastname: Wang
authors.affiliation: Section of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Graduate Institute of Environmental Education, National Kaohsiung Normal University, Kaohsiung, Taiwan.
authors.forename: Yao-Shen
authors.initials: YS
authors.lastname: Chen
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage / Q000009:adverse effects*; D044466:Asian People; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D065906:Hyperlactatemia / Q000139:chemically induced / Q000473:pathology; D008297:Male; D000068898:Raltegravir Potassium / Q000008:administration & dosage / Q000009:adverse effects*; D012206:Rhabdomyolysis / Q000139:chemically induced* / Q000150:complications / Q000473:pathology*; D013624:Taiwan; D013995:Time
chemical_list: D044966:Anti-Retroviral Agents; D000068898:Raltegravir Potassium
keywords: Antiretroviral agents; Hyperlactatemia; Raltegravir; Rhabdomyolysis