Abstract
To date only one published case report exists of the HIV protease inhibitor atazanavir (ATV) causing central nervous system (CNS) side effects. We report two such cases of patients experiencing disabling CNS side effects shortly after starting ATV-containing regimens whose symptoms only resolved after withdrawing the drug.
Highlights
A 39-year-old, homosexual man from the Philippines was diagnosed with HIV and hepatitis B (HBV) infections
This had progressed and after the second week, 4 hours after taking his antiretrovirals in the morning he became disorientated in time and place, described severe vertigo and became tremulous. These episodes occurred for 5 consecutive days and lasted approximately 3 hours each time. He tried taking his antiretrovirals at night; his partner reported that 3 hours after taking the medication he woke up from sleep completely disorientated and complained of nausea and extreme vertigo rendering him unable to walk
The patient returned to clinic after 10 days complaining of mild dizziness in the first week, which progressed to severe positional vertigo, tremulousness and nausea in the second week
Summary
A 39-year-old, homosexual man from the Philippines was diagnosed with HIV (no resistance mutations, CD4 count 315 cells/ μl, HIV viral load 120,033 copies/ml) and hepatitis B (HBV) infections He returned to the clinic 2 weeks later complaining of weakness, mild headache, agitation and difficulty sleeping in the first week of taking his new regimen. This had progressed and after the second week, 4 hours after taking his antiretrovirals in the morning he became disorientated in time and place, described severe vertigo and became tremulous. He tried taking his antiretrovirals at night; his partner reported that 3 hours after taking the medication he woke up from sleep completely disorientated and complained of nausea and extreme vertigo rendering him unable to walk.
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