Reactions 1680, p114 - 2 Dec 2017 Sinus bradycardia: case report A 38-year-old woman developed sinus bradycardia during treatment with darunavir/ritonavir [dosage and route not stated]. The woman presented to the hospital with a complaint of worsening visual blurring in the previous 2 weeks. Her medical history included HIV-1 infection for 2 years. She was also diagnosed with cytomegalovirus (CMV) retinitis of the right eye on her previous hospitalisation and was treated with ganciclovir. She was also initiated on antiretroviral therapy including darunavir/ritonavir and emtricitabine/tenofovir. However, she was not taking the medications prior to the admission. Her vital signs were stable with a heart rate (HR) of 72 90 beats/min. She was hospitalised with a diagnosis of severe bilateral necrotising CMV retinitis. She was stated on foscarnet. She also received ganciclovir. She was restated on antiretroviral therapy with darunavir/ritonavir and opportunistic infection prophylaxis was continued with azithromycin and atovaquone for a history of sulfa allergy. She was stable until day 5 of hospital stay. On day 5 of treatment with darunavir/ritonavir, she developed episodes of bradycardia with HR of 50 60 beats/min. Her HR dropped further to 44 52 beats/min over the next 2 days. ECG revealed sinus bradycardia. Non-specific T-wave changes in the lateral leads were also noted, but were an old finding and remained stable compared to previous studies. Treatment with darunavir/ritonavir was discontinued and was switched to emtricitabine/tenofovir. Bradycardia resolved within 48 hours. She completed a 3-week course of foscarnet therapy with improvement of her vision. No additional episodes of bradycardia were observed. Author comment: "We present a case of transient sinus bradycardia induced by darunavir-ritonavir in a patient with HIV/AIDS." Gonzales Zamora JA, et al. Sinus bradycardia induced by darunavir-ritonavir in a patient with acquired immunodeficiency syndrome. Infection 45: 721-723, No. 5, Oct 2017. Available from: URL: http://doi.org/10.1007/s15010-017-1065-5 - USA 803284867 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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