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Raltegravir-associated Diabetic Ketoacidosis in a Patient with HIV Infection: A Case Report.

Abstract
Antiretroviral drugs, especially protease inhibitors (PI), are known to induce disorders of lipid and glucose metabolism. However, there are only a few reports of these side effects in patients treated with integrase strand transfer inhibitors (INSTI). We encountered the case of a 46-year-old man who had been treated for type 2 diabetes with diet and exercise. He contracted immunodeficiency virus (HIV) infection two years earlier and received highly active antiretroviral therapy (HAART). Three months before the current admission, HAART was switched from a non-nucleic acid reverse transcriptase inhibitor (NNRTI) to an INSTI (raltegravir: 800 mg/day). He developed diabetic ketoacidosis and was admitted for treatment. The state of health prior to admission was not well documented but he showed no clinical signs of acute infection. Accordingly, diabetic ketoacidosis was considered to be associated with INSTI. Diabetic ketoacidosis was treated appropriately and blood glucose level was controlled with medications before discharge from the hospital. Although the present case does not provide direct evidence for raltegravir-induced diabetic ketoacidosis, we caution physicians about the potential of such side effect associated with the use of INSTI.
AuthorsMari Horikawa, Masao Toyoda, Nobumichi Saito, Moritsugu Kimura, Takako Kobayashi, Atsushi Takagi, Masafumi Fukagawa
JournalThe Tokai journal of experimental and clinical medicine (Tokai J Exp Clin Med) Vol. 43 Issue 1 Pg. 19-23 (Apr 20 2018) ISSN: 2185-2243 [Electronic] Japan
PMID29637535 (Publication Type: Case Reports, Journal Article)
Chemical References
  • HIV Integrase Inhibitors
  • Raltegravir Potassium
Topics
  • Diabetes Mellitus, Type 2 (complications, therapy)
  • Diabetic Ketoacidosis (chemically induced, therapy)
  • HIV Infections (complications, drug therapy)
  • HIV Integrase Inhibitors (administration & dosage, adverse effects)
  • Humans
  • Male
  • Middle Aged
  • Raltegravir Potassium (administration & dosage, adverse effects)

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