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Acute interstitial nephritis due to dolutegravir: The first case reported
Rui Barata1, Bernardo Marques da Costa1, David Navarro1
1Nephrology Department, Hospital Curry Cabral - Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal.
Nefrologia
|November 27, 2022
Summary
This case report details a patient with HIV-associated nephropathy who developed acute interstitial nephritis after starting dolutegravir. Early recognition and drug cessation are crucial for managing this rare antiretroviral therapy side effect.
Area of Science:
- Nephrology
- Infectious Diseases
- Pharmacology
Background:
- HIV infection frequently leads to chronic kidney disease, specifically HIV-associated nephropathy.
- Antiretroviral therapy is essential for managing HIV but can have renal side effects.
- This case involves a patient with uncontrolled HIV and pre-existing chronic kidney disease.
Observation:
- A 44-year-old woman with HIV-associated nephropathy developed eosinophilia and declining kidney function after initiating dolutegravir.
- Kidney biopsy confirmed acute interstitial nephritis, temporally linked to dolutegravir use.
- This represents the first reported instance of acute interstitial nephritis attributed to dolutegravir.
Findings:
- Dolutegravir was identified as the likely cause of acute interstitial nephritis.
- Cessation of dolutegravir and initiation of corticosteroids led to moderate renal function improvement.
- The case highlights a previously undocumented renal adverse effect of this antiretroviral medication.
Implications:
- Clinicians should consider dolutegravir-induced acute interstitial nephritis in HIV patients presenting with unexplained renal dysfunction and eosinophilia.
- Awareness of this potential adverse effect is critical for timely diagnosis and management.
- Further research into the renal safety profile of dolutegravir and other antiretrovirals is warranted.
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