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HIV with elevated CK levels

Pari Basharat, Lisa Christopher-Stine
The idiopathic inflammatory myopathies (IIMs) comprise a group of autoimmune disorders that target skeletal muscle. They are characterized by typical laboratory and clinical features including muscle weakness, elevated muscle enzymes, characteristic histopathology of muscle biopsies, as well as electromyography abnormalities. The IIMs are divided into polymyositis, dermatomyositis, inclusion body myositis, nonspecific myositis, and immune-mediated necrotizing myopathy (IMNM). IMNM is distinguished by the absence of primary inflammation on muscle biopsy...
December 2015: Current Rheumatology Reports
David C Boettiger, Stephen Kerr, Rossana Ditangco, Romanee Chaiwarith, Patrick Ck Li, Tuti Parwati Merati, Thuy Thi Thanh Pham, Sasisopin Kiertiburanakul, Nagalingeswaran Kumarasamy, Saphonn Vonthanak, Christopher Kc Lee, Nguyen Van Kinh, Sanjay Pujari, Wing Wai Wong, Adeeba Kamarulzaman, Fujie Zhang, Evy Yunihastuti, Jun Yong Choi, Shinichi Oka, Oon Tek Ng, Pacharee Kantipong, Mahiran Mustafa, Winai Ratanasuwan, Nicolas Durier, Matthew Law
BACKGROUND: The World Health Organization recommends HBV-HIV-coinfected individuals start antiretroviral therapy containing tenofovir. Here we describe first-line tenofovir use and treatment outcomes in coinfected patients in Asia. METHODS: HBV surface antigen positive patients enrolled in the TREAT Asia HIV Observational Database who started first-line antiretroviral therapy were included. Logistic regression adjusted for period of treatment initiation was used to determine factors associated with tenofovir use...
2016: Antiviral Therapy
Yu Kaku, Shoko Kodama, Makiko Higuchi, Akihiro Nakamura, Masataka Nakamura, Tomoe Kaieda, Soichiro Takahama, Rumi Minami, Tomoya Miyamura, Eiichi Suematsu, Masahiro Yamamoto
Human immunodeficiency virus (HIV) infection disturbs the host's immune function and often coexists with various autoimmune and/or systemic rheumatic diseases with manifestations that sometimes overlap with each other. We herein present the case of a 43-year-old Japanese man infected with HIV who exhibited elevated serum creatine kinase and transaminases levels without any symptoms. He was diagnosed with autoimmune hepatitis, polymyositis and Sjögren's syndrome and received combined antiretroviral therapy (cART); however, the laboratory abnormalities persisted...
2015: Internal Medicine
Leonardo Calza, Ilaria Danese, Vincenzo Colangeli, Giacomo Vandi, Roberto Manfredi, Nicolò Girometti, Marco Borderi, Lucia Appolloni, Cristina Puggioli, Pierluigi Viale
To evaluate the frequency of myopathy and serum creatine kinase (CK) elevation associated with the use of the integrase inhibitor raltegravir we conducted a retrospective, cohort analysis assessing the incidence of skeletal muscle toxicity among HIV-infected patients treated with raltegravir. Adult HIV-infected patients who started a raltegravir-containing therapy were enrolled into the study. The skeletal muscle toxicity was defined by the presence of one or more of the following parameters: (1) isolated and significant CK elevation without signs or symptoms; (2) diffuse myalgia without weakness; (3) proximal muscle weakness; (4) rhabdomyolysis...
December 2014: AIDS Research and Human Retroviruses
Noemi Mihalik, Eszter Bodrogi, Csaba Nádor, Eszter Ostorházi, Sarolta Kárpáti, Márta Marschalkó
No abstract text is available yet for this article.
2014: Acta Dermatovenerologica Croatica: ADC
Zahir Osman Eltahir Babiker, Tom Wingfield, James Galloway, Neil Snowden, Andrew Ustianowski
The diagnosis of primary HIV-1 infection can be challenging, especially in the absence of reported risks or when presenting features are unusual and uncommon. We report an atypical case of primary HIV-1 infection with HIV-1 subtype C in a 61-year old Caucasian man who presented with extreme hyperferritinaemia without iron overload and marked elevation of serum creatine kinase without rhabdomyolysis. In view of his symptomatic seroconversion and low baseline CD4+ T-lymphocyte count, the patient was treated promptly with combination antiretroviral therapy...
January 2015: International Journal of STD & AIDS
J McAllister, P Read, A McNulty, W W Y Tong, A Ingersoll, A Carr
OBJECTIVES: Three-drug nonoccupational post-exposure prophylaxis (NPEP) typically includes co-formulated emtricitabine-tenofovir (FTC-TDF) and a protease inhibitor. However, protease inhibitors can cause significant toxicities, can interact with prescribed and illicit drugs, and work late in the viral cycle. Agents that act before viral integration into host DNA may have efficacy advantages. Raltegravir (RAL) is a good candidate for NPEP as it has few side effects or drug interactions and acts prior to HIV integration...
January 2014: HIV Medicine
Ricardo Tristão-Sá, Claire Fernandes Kubelka, Eliana Zandonade, Sônia Maria Oliveira Zagne, Natally de Souza Maciel Rocha, Luiza Oliveira Zagne, Nathália Félix Araújo, Beatriz Amin, Flávia Fazoli, Luiz José de Souza, Oswaldo Gonçalves Cruz, Rivaldo Venâncio da Cunha, Delso do Nascimento, Iris Bucher Froes, Rita Maria Ribeiro Nogueira
INTRODUCTION: To analyze the liver dysfunction and evolution of signs and symptoms in adult dengue patients during a two-month follow-up period. METHODS: A prospective cohort study was conducted in Campos dos Goytacazes, Rio de Janeiro, Brazil, from January to July, 2008. The evolution of laboratory and clinical manifestations of 90 adult dengue patients was evaluated in five scheduled visits within a two-month follow-up period. Twenty controls were enrolled for the analysis of liver function...
December 2012: Revista da Sociedade Brasileira de Medicina Tropical
Frederick J Lee, Janaki Amin, Mark Bloch, Sarah L Pett, Debbie Marriott, Andrew Carr
OBJECTIVE/DESIGN: Raltegravir is uncommonly associated with rhabdomyolysis and grade 3-4 creatine kinase (CK) elevation. In this cross-sectional study, we compared the prevalence of skeletal muscle toxicity in HIV-infected adults receiving raltegravir with that of a control group. METHODS: Adults receiving combination antiretroviral therapy were recruited consecutively. Assessments included physical examination, an exercise questionnaire, and blood testing for CK, troponin T, and raltegravir trough levels...
April 15, 2013: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Dai Watanabe, Munehiro Yoshino, Hiroki Yagura, Kazuyuki Hirota, Hitoshi Yonemoto, Hiroki Bando, Keishiro Yajima, Yusuke Koizumi, Hiroshi Otera, Shinjiro Tominari, Yasuharu Nishida, Takeshi Kuwahara, Tomoko Uehira, Takuma Shirasaka
Recently, 2 monoclonal antibodies that specifically inhibit mitochondrial creatine kinase (MtCK) activity have been developed. In this study, we measured the serum MtCK activity in HIV-1-infected individuals (n = 100) by employing a novel method using these antibodies. The mean serum MtCK activity in 44 patients treated with highly active antiretroviral therapy (HAART) including tenofovir disoproxil fumarate (TDF) was 16.0 IU/L. The MtCK activity was significantly higher in patients receiving TDF than in those receiving HAART without TDF (3...
October 2012: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Amedeo F Capetti, Daria Pocaterra, Patrizia Zucchi, Laura Carenzi, Giuliano Rizzardini
We report the surprising yet sought impact that an antiretroviral (ARV) regimen containing maraviroc had on an HIV-infected and heavily highly active antiretroviral therapy (HAART)-experienced patient with chronic polymyositis. The patient had elevated creatine kinase (CK) levels in serum for 6 years, reaching peaks over 900 U/L and showing only partial response to high-dose steroids, not responding to HAART withdrawal. The disease started while on second-line HAART and gradually impaired his muscular function, leading to the absolute loss of the ability to stand on his legs...
July 2010: Journal of the International Association of Physicians in AIDS Care: JIAPAC
Jose Orsini, Abhijeet Nadkarni, Julie Chen, Nina Cohen
PURPOSE: A case of propofol infusion syndrome in a patient with respiratory failure and sepsis is reported. SUMMARY: A 36-year-old Hispanic woman was admitted to the medical intensive care unit for treatment of respiratory failure and sepsis, likely secondary to pneumonia. Her medical history included human immunodeficiency virus infection and chronic hepatitis C virus infection. She was intubated and placed on mechanical ventilation. Empirical i.v. antimicrobial therapy was initiated with vancomycin, moxifloxacin, piperacillin-tazobactam, trimethoprim-sulfamethoxazole, and micafungin, along with corticosteroids and vasopressors...
May 15, 2009: American Journal of Health-system Pharmacy: AJHP
Rao L Divi, Sarah L Leonard, Brettania L Walker, Maryanne M Kuo, Marie E Shockley, Marisa C St Claire, Kunio Nagashima, Steven W Harbaugh, Jeffrey W Harbaugh, Miriam C Poirier
Antiretroviral nucleoside reverse transcriptase inhibitors (NRTIs), given to human immunodeficiency virus-1-infected pregnant women to prevent vertical viral transmission, have caused mitochondrial dysfunction in some human infants. Here, we examined mitochondrial integrity in skeletal muscle from offspring of pregnant retroviral-free Erythrocebus patas dams administered human-equivalent NRTI doses for the last 10 weeks of gestation or for 10 weeks of gestation and 6 weeks after birth. Exposures included no drug, Zidovudine (AZT), Lamivudine (3TC), AZT/3TC, AZT/Didanosine (ddI), and Stavudine (d4T)/3TC...
September 2007: Toxicological Sciences: An Official Journal of the Society of Toxicology
Holger Schmid, Dieter Mühlbayer, Jörg Röling, Thomas Sternfeld, Boris Jülg, Uwe Schlattner, Peter J Nelson, Johannes R Bogner, Theo Wallimann, Frank D Goebel
OBJECTIVE: To evaluate the prevalence and origin of macroenzyme creatine kinase type 2 (Macro CK2) in HIV-1-infected patients on antiretroviral treatment. DESIGN: CK, CK-MB activity and protein weight, electrophoretic behaviour, glomerular filtration rate (GFR), aspartate aminotransferase (AST), alanine aminotransferase (ALT), bone alkaline phosphatase (AP), beta2-microglobulin serum levels and proteinuria were analysed in 468 HIV-infected outpatients. Sera with detectable Macro CK2 were further analysed using immunoblotting...
2006: Antiviral Therapy
Tonio V Piscopo, Paul S McDonald, Alastair R O Miller
Creatine phosphokinase (CPK) estimations are done routinely in some HIV clinics, irrespective of patient symptoms. We studied patients attending the Worcestershire HIV clinic between 1987 and 2001 to identify whether routine elevations in serum levels of CPK in patients with HIV were associated with clinical features of muscle disease (CFMD), and whether such elevations influenced patient management. There was no association between CFMD and a rise in CPK. Major rises of CPK >400 IU/L were significantly associated with CFMD...
January 2006: International Journal of STD & AIDS
Rao L Divi, Sarah L Leonard, Maryanne M Kuo, Brettania L Walker, Christine C Orozco, Marisa C St Claire, Kunio Nagashima, Steven W Harbaugh, Jeffrey W Harbaugh, Chandrasekhar Thamire, Craig A Sable, Miriam C Poirier
Hearts from 1-yr-old Erythrocebus patas monkeys were examined after in utero and 6-wk-postbirth exposure to antiretroviral nucleoside reverse transcriptase inhibitors (NRTIs). Protocols were modeled on those given to human immunodeficiency virus (HIV)-1-infected pregnant women. NRTIs were administered daily to the dams for the last 20% or 50% of gestation, and to the infants for 6 wk after birth. Exposures included: no drug (n = 4); Zidovudine, 3'-azido-3'-deoxythymidine (AZT; n = 4); AZT/Lamivudine, (-)-beta-L-2', 3'-Dideoxy-3'-thiacytidine (Epivir, 3TC) (n = 4); AZT/Didanosine (Videx, ddI) (n = 4); and Stavudine (Zerit, d4T)/3TC (n = 4)...
2005: Cardiovascular Toxicology
Nieves Sopena, Maria Luisa Pedro-Botet, Miquel Sabrià, Delia García-Parés, Esteban Reynaga, Marian García-Nuñez
The objective of this study was to compare epidemiological data and clinical presentation of community-acquired pneumonia (CAP) caused by Streptococcus pneumoniae, Legionella pneumophila or Chlamydia pneumoniae. From May 1994 to February 1996, 157 patients with S. pneumoniae (n = 68), L. pneumophila (n = 48) and C. pneumoniae (n = 41) pneumonia with definitive diagnosis, were prospectively studied. The following comparisons showed differences at a level of at least p < 0.05. Patients with S. pneumoniae pneumonia had more frequently underlying diseases (HIV infection and neoplasm) and those with C...
2004: Scandinavian Journal of Infectious Diseases
Susama Verma, Elena Micsa, Lydia Estanislao, David Simpson
HIV affects many organs of the body, including the nervous system. As a result, a series of neurologic complications have created challenges for scientists and clinicians alike. Among these, HIV-associated neuropathy and myopathy may occur at all stages of the disease process. Of the neuropathies, distal symmetrical polyneuropathy is the most common form. The pathogenesis of primary HIV neuropathy is unknown. Other types of neuropathy seen in HIV-infected subjects include toxic neuropathy, inflammatory demyelinating polyneuropathy, progressive polyradiculopathy, and mononeuritis multiplex...
January 2004: Current Neurology and Neuroscience Reports
Steven C Zell, Surl Nielsen
Muscular fatigue may result from HIV infection, and may be associated with antiretroviral drug treatment. Clinical features linked to muscle biopsy findings may assist in determining etiology, and guide treatment decisions. This case series examined HIV patients in an ambulatory HIV clinic who received antiretroviral therapy, and complained of unexplained muscular fatigue. Clinical features with measurement of acid-base status, levels of lactate, aminotransferases, triglycerides and creatine kinase were correlated to light and electron microscopic results of muscle biopsy...
2002: Journal of the International Association of Physicians in AIDS Care: JIAPAC
Randall W Johnson, Francis M Williams, Salahuddin Kazi, Mazen M Dimachkie, John D Reveille
OBJECTIVE: To determine the clinical course and optimum treatment of human immunodeficiency virus (HIV)-associated myositis. METHODS: Sixty-four patients attending a county outpatient HIV/acquired immunodeficiency syndrome facility were referred for the presence of elevated creatine kinase (CK) levels or muscle weakness. Patients underwent neurologic and rheumatologic evaluation, electromyography, and muscle biopsy after exclusion for recreational drug or alcohol use, metabolic/endocrine disorders, zidovudine therapy, and other infections...
April 15, 2003: Arthritis and Rheumatism
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