Ritonavir and Gout

Title: Is ritonavir boosting associated with gout?
Creighton S, et al.
Publication: Int J STD AIDS. 2005 May;16(5):362-4.

Treatment of HIV-positive patients with ritonavir, a protease-inhibiting drug that suppresses the replication of HIV, has been linked with high levels of uric acid in the blood (hyperuricemia). However, this increased level of uric acid is usually asymptomatic and gout is rarely reported.

In this study, the author studied 1,825 HIV-positive patients seen in a London HIV clinic over a two-year period. 18 of these patients had gout, 15 of whom were receiving antiretroviral therapy.

Of these 18 gout patients, 7 had predisposing risk factor for gout (haemotological malignancy, such as leukemia, lymphoma, and related blood disorders as well as pyrazinamide therapy for treating tuberculosis infection).

Of the remaining 11 patients with gout, 2 were not on medications and the remaining 8 were receiving ritonavir. These 8 patients had symptoms showing lipodystrophy (defective metabolism of fat) and dyslipidaemia (abnormal levels of lipids and lipoproteins in the blood)

According to this study, about 44% of HIV-positive patients with gout were receiving ritonavir. In comparison, only 11% of all HIV-positive patients without gout were receiving the drug.

The authors concluded that gout can show up in patients who had risk factors for gout, had defective lipid metabolism and were receiving ritonavir as part of their treatment of HIV.

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