As greater numbers of human immunodeficiency virus (HIV)-infected individuals live to middle-age and beyond, there is growing concern that
elevated cholesterol and
lipid values will lead to cardiovascular complications in such patients. Furthermore, several of the highly active antiretroviral
therapies (
HAART) used to reduce levels of circulating HIV and extend
acquired immunodeficiency syndrome (
AIDS)-related survival are associated with a rise in plasma
lipids. Anecdotal reports suggest such rises may be linked to cardiovascular complications. Herein, we review the case of a 74-year-old HIV-infected man with advanced
coronary artery disease. He was prescribed
simvastatin for control of
hyperlipidemia and within 4 weeks developed
muscle pain, proximal
muscle weakness,
myoglobinuria, and a markedly elevated
creatinine phosphokinase (CPK).
Simvastatin was discontinued, and
rhabdomyolysis improved rapidly with conservative care. This report emphasizes this rare, but potentially significant, side effect of
statin anticholesterol agents. Medical providers who prescribe
statins must remember to check CPK levels when their HIV-infected patients complain of
muscle pain. Discontinuing the offending
drug will usually result in rapid diminution of
muscle pain and
inflammation and improve muscle strength.