HIV に 感染 し て いる 女性 の 急性 ラブドミオリス ― 抗レトロウイルス 治療 の せい で は あり ませ ん
Léa Probst1, Maxime Dubois2, Clémence Risser3
1HIV-infection Care Center, CHU de Strasbourg, Le Trait d'Union, Strasbourg, France.
International journal of STD & AIDS
|September 2, 2025
まとめ
抗レトロウイルス治療をダウレトグラビールとラミブジン (Dovato®) で再開した後,HIV感染者の女性は筋痛とラブドミオリスを発症しました. コルチコステロイドとメトトレキサートで症状が治りました.
科学分野:
- 感染症
- リウマトロジ
- 臨床薬理学
背景:
- 抗レトロウイルス治療 (ART) はHIV感染の管理に不可欠です.
- 薬剤誘発性筋痛症とラブドミオリスは,ARTの潜在的な副作用です.
- 皮質筋炎は,筋肉の弱さで表れるイディオパシー性炎症性筋症です.
研究 の 目的:
- 肌痛とラブドミオリシスを伴う皮膚ミオシスの症例をHIV感染者に報告する.
- 抗レトロウイルス薬と炎症性筋症の発症の潜在的な関連を調べる.
- この珍しい病気の診断と成功管理について説明します
主な方法:
- 49歳のHIV感染者の臨床事例です
- 患者さんの抗レトロウイルス治療歴の見直し,中断や変化を含む.
- 血清検査 (Mi-2 抗体),MRI,筋肉バイオプシーを含む診断検査
- コルチコステロイドとメトトレキサートで治療し,その後,ドゥルテグラビールとラミブジンで再挑戦する.
主要な成果:
- 患者さんは,重度の筋痛,弱さ,ラブドミオリシスが,ドゥルテグラビールとラミブジン (Dovato®) の投与を再開してから1ヶ月後に発症しました.
- 薬剤毒性の初期疑惑は,ART療法の変更後の改善によって支持されなかった.
- 皮膚筋炎の診断は,陽性なMi-2抗体,MRI検査,筋肉生検によって確認された.
- 症状は免疫抑制療法 (コルチコステロイド,メトトレキサート) によって解消した.
結論:
- 皮膚炎は,ARV治療を受けているHIV患者における薬剤誘発性筋痛症を模倣する.
- 早期の正確な診断は,免疫抑制療法を含む適切な管理に不可欠です.
- デルテグラヴィルとラミブジン (Dovato®) の再投与は,皮膚炎の治療に成功した後,よく耐えられ,初期症状は,この特定のART組み合わせによって直接引き起こされなかったことを示唆しています.
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