V. Gheorghiţă 1, Cristina Loredana Benea 1
1 National Institute of Infectious Diseases, “Prof Dr Matei Balş”, Bucharest, Romania
Abstract
We would like to present the case of a 44-year old man, who was admitted and diagnosed in our hospital with HIV infection (stage C2) with abdominal tuberculosis as AIDS defining disease, oral candidiasis and deep venous thrombosis (tibial vein). We initiated standard tuberculostatic treatment with four first line drugs and after two weeks we started antiretroviral therapy (ARV) with Zidovudine (ZDV), Lamivudine (3TC) and Efavirenz (EFV). We recorded a rapid growth of CD4 to 296/mmc, with immune reconstitution syndrome (IRIS). In the next two weeks, the patient developed severe neuropsychiatric events most likely induced by EFV, ARV therapy thus ceased. Four months later with relative clinical favorable evolution a new viro-immunological evaluation was performed, with CD4 211/mmc and HIV RNA 5,9 log 10 cp/ml. ARV therapy was resumed with Abacavir (ABV), 3TC and Raltegravir (RAL) in double dose (800 mg BID) with good tolerance and rapid immunological and virological response. In conclusion, Raltegravir stands as an alternative for HIV patients, naive or experienced, with pulmonary or extrapulmonary tuberculosis, being a potent antiretroviral with favourable profile concerning tolerability and drug interactions.