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Serum creatine phosphokinase monitoring in patients infected with HIV

Tonio V Piscopo1, Paul S McDonald, Alastair R O Miller

  • 1Worcestershire HIV Clinic, Worcestershire Acute Hospitals NHS Trust, Worcestershire Royal Hospital, Charles Hastings Way, Worcester WR5 1DD, UK. tpiscopo@maltanet.net

International Journal of STD & AIDS
|January 18, 2006
PubMed

Insights

Routine creatine phosphokinase (CPK) monitoring in HIV patients without muscle disease symptoms is not supported by this study. Elevated CPK levels were rarely associated with clinical features of muscle disease (CFMD) or changes in patient management.

Area of Science:

  • Clinical Medicine
  • Biochemistry
  • Infectious Diseases

Background:

  • Routine creatine phosphokinase (CPK) monitoring is performed in some human immunodeficiency virus (HIV) clinics, regardless of patient symptoms.
  • The clinical significance of elevated CPK levels in asymptomatic HIV patients remains unclear.

Purpose of the Study:

  • To determine if routine serum CPK elevations in HIV patients are associated with clinical features of muscle disease (CFMD).
  • To assess whether CPK elevations influence patient management in HIV clinics.

Main Methods:

  • Retrospective study of patients attending the Worcestershire HIV clinic from 1987 to 2001.
  • Analysis of serum CPK levels in relation to the presence or absence of CFMD.
  • Evaluation of changes in patient management following CPK level monitoring.

Main Results:

  • No association was found between CFMD and a general rise in CPK levels.
  • Major CPK elevations (>400 IU/L) were significantly associated with CFMD.
  • No patient without CFMD exhibited a persistent CPK rise (>200 IU/L); management rarely changed due to enzyme elevations.

Conclusions:

  • Routine CPK monitoring in asymptomatic HIV patients is not supported by this study's findings.
  • The likelihood of detecting a significant and persistent CPK rise in HIV patients without CFMD is low.
  • CPK monitoring should be considered in the context of specific clinical indications rather than routine practice.

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