Here, we describe a case of an HIV-infected patient with right lower limb oedema that appeared after initiation of tenofovir and emtricitabine treatment. The patient was fully investigated by serial heart and vessel echo-Doppler examination. Oedema of the lower limb was attributed to a transient drug-induced fivefold increase in peripheral artery flow, which was induced by a reduction in peripheral arterial resistance. The possible mechanisms of disease are discussed.
References
1.
DolL., GeffrayL., el KhouryS., CevallosR., VeyssierP.Edema of the lower extremities in a HIV seropositive patient: secondary effect of ritonavir?Presse Med1999; 28: 75.
2.
LascauxA-S, LespritP., BertocchiM., LevyY.Inflammatory oedema of the legs: a new side-effect of lopinavir.AIDS2001; 15: 819–821.
3.
Eyer-SilvaW.A., Neves-MottaR., PintoJ.F.C., Morais-de-SàC.A.. Inflammatory oedema associated with lopinavir-including HAART regimens in advanced HIV-1 infection: report of 3 cases.AIDS2002; 16: 673–674.
4.
GuyotS., HayozD., TelentiA., CavassiniM.Peripheral oedema and high arterial blood flow as a complication of antiretroviral therapy.AIDS2004; 18: 356–358.
5.
PeriardD., CavassiniM., TafféP.. High prevalence of peripheral arterial disease in HIV-infected persons.Clin Infect Dis2008; 46: 761–767.
6.
SolagesA., VitaJ.A., ThorntonD.J.Endothelial function in HIV-infected persons.Clin Infect Dis2006; 42: 1325–1332.
7.
FlammerA.J., VoN.T.T., LedergerberD.Effect of atazanavir versus other protease inhibitor-containing antiretroviral therapy on endothelial function in HIV-infected persons: randomised controlled trial.Heart2009; 95: 385–390.
8.
DubéM.P., GorskiJ.C., ShenC.Severe impairment of endothelial function with the HIV-1 protease inhibitor indinavir is not mediated by insulin resistance in healthy subjects.Cardiovasc Toxicol2008; 8: 15–22.
9.
TorrianiF.J., KomarowL., ParkerR.A.Endothelial function in human immunodeficiency virus-infected antiretroviral-naive subjects before and after starting potent antiretroviral therapy: the ACTG (AIDS Clinical Trials Group) Study 5152s.J Am Coll Cardiol2008; 52: 569–576.
