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Acute rhabdomyolysis in patients infected by human immunodeficiency virus

Departments of Pathology (Neuromuscular Disorders, ER 269) (Drs. Chariot, Authier, and Gherardi, and Ms. Ruet), Toxicology (Dr. Chariot and Ms. Ruet), and Immunology (Dr. Lévy), Hôpital Henri Mondor, Créteil, France.

To delineate the spectrum of rhabdomyolysis associated with human immunodeficiency virus (HIV) infection, we reviewed the clinical and pathologic data from nine HIV-infected individuals with acute rhabdomyolysis, and pooled data with those of 11 previously reported cases. Patients with rhabdomyolysis were at all stages of HIV infection and could be classified into three groups: (1) HIV-associated rhabdomyolysis (7 of 20), including rhabdomyolysis in primary HIV infection, recurrent rhabdomyolysis, and isolated rhabdomyolysis; (2) rhabdomyolysis induced by drugs (6 of 20), including didanosine; and (3) rhabdomyolysis at the end stage of acquired immunodeficiency syndrome (7 of 20), including opportunistic infections of muscle and rhabdomyolysis without a definite cause. Because prognosis, in part, depends on the cause of rhabdomyolysis, recognition of drug-induced or opportunistic infectious muscle disorders is required.

Address correspondence and reprint requests to Dr. Patrick Chariot, Department of Pathology, Hôpital Henri Mondor, 94010 Créteil, France.

Supported in part by grants to Dr. Chariot from Association Française contre les Myopathies and to Dr. Gherardi from the Agence Nationale pour la Recherche sur le SIDA and by a Concerted Action of the European communities on "Neuropathology of AIDS."

Received December 2, 1993. Accepted in final form March 14, 1994.

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