Abstract：
UNASSIGNED: Patients with HIV have a higher incidence of rhabdomyolysis compared with the HIV negative population because of medication-related myotoxicity and drug-drug interactions. Statins and antiretroviral therapy have been previously reported to cause myopathy in patients with HIV when used alone or in combination. In this study, we describe a case of biopsy-proven noninflammatory and nonautoimmune myopathy associated with the use of simvastatin and Genvoya (elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide fumarate) and review 3 previously reported similar cases. Our patient presented with acute proximal limb weakness and significantly elevated serum creatine kinase. Muscle biopsy revealed scattered degenerating and regenerating muscle fibers without evidence for an inflammatory process. She did not respond to empiric treatment with high-dose intravenous steroids and intravenous immunoglobulin. Her creatine kinase only began to downtrend after discontinuation of both simvastatin and Genvoya, and she returned to baseline function at 2-month follow-up. Our case highlights the importance of recognizing drug-drug interactions between HIV and statin medications in causing significant noninflammatory myopathy. In these patients, both categories of medications need to be discontinued for recovery.
摘要：
UNASSIGNED：由于药物相关的肌毒性和药物-药物相互作用，与HIV阴性人群相比，HIV患者的横纹肌溶解症发生率更高。先前有报道称，他汀类药物和抗逆转录病毒疗法在单独或联合使用时会引起HIV患者的肌病。在这项研究中,我们描述了一例经活检证实的非炎性和非自身免疫性肌病与使用辛伐他汀和Genvoya(elvitegravir/cobicystat/恩曲他滨/富马酸替诺福韦艾拉酚胺)相关,并回顾了3例以前报道的类似病例.我们的患者表现为急性近端肢体无力和血清肌酸激酶显着升高。肌肉活检显示分散的退化和再生肌纤维，没有炎症过程的证据。她对大剂量静脉注射类固醇和静脉注射免疫球蛋白的经验性治疗没有反应。她的肌酸激酶在停止辛伐他汀和Genvoya后才开始下降，在2个月的随访中，她恢复了基线功能。我们的案例强调了认识到HIV和他汀类药物之间的药物-药物相互作用在引起严重非炎性肌病中的重要性。在这些患者中,这两类药物都需要停药以恢复.
