PT  - JOURNAL ARTICLE
AU  - Sylvain Raoul Simeni Njonnou
AU  - Sophie Henrard
AU  - Lamya Noure
AU  - Jean-Christophe Goffard
TI  - Severe rhabdomyolysis and acute asymptomatic pancreatitis following the concomitant use of Biktarvy in the setting of hyperosmolar diabetic crisis
AID  - 10.1136/bcr-2020-234483
DP  - 2020 Jul 01
TA  - BMJ Case Reports
PG  - e234483
VI  - 13
IP  - 7
4099  - http://casereports.bmj.com/content/13/7/e234483.short
4100  - http://casereports.bmj.com/content/13/7/e234483.full
SO  - BMJ Case Reports2020 Jul 01; 13
AB  - Biktarvy (bictegravir/emtricitabine/tenofovir alafemanide), which has been recently approved for the treatment of HIV, is a single-pill regimen that associates bictegravir and a novel integrase strand transfer inhibitor (INSTI) with a combination of two nucleoside reverse transcriptase inhibitors (NRTI) of emtricitabine and tenofovir alafemanide. Among treatment complications, rhabdomyolysis has been reported in association with some NRTI and INSTI but never with bictegravir. Acute pancreatitis has also been reported recently with another INSTI, dolutegravir. We report here a 62-year-old man with diabetes and HIV infection, and receiving Biktarvy for 1 month. He presented to the emergency department for muscular pain and fatigue. He was on treatment with Descovy (tenofovir alafenamide/emtricitabine) and Viramune (nevirapine) for 2 years but he recently asked for a regimen simplification. Severe rhabdomyolysis and acute pancreatitis were diagnosed. Although the aetiology of these events could be multifactorial, it cannot be ruled out that this episode could be linked to a potential side effect of bictegravir.