CARDIOMYOPATHY ASSOCIATED WITH ANTIRETROVIRAL THERAPY IN PATIENTS WITH HIV-INFECTION - A REPORT OF 6 CASES

Dilated cardiomyopathy has been noted with increasing frequency in patients infected with the human immunodeficiency virus type 1 (HIV). The role of direct HIV cytotoxicity, coinfection with other viruses (such as coxsackievirus and cytomegalovirus), other nonviral opportunistic infections, drug hypersensitivity and toxicity, nutritional deficiencies, and autonomic dysfunction in HIV-associated cardiomyopathy is poorly understood. We describe six cases of cardiomyopathy clinically associated with antiretroviral therapy using either zidovudine, 2'-3'-dideoxyinosine (ddI) or 2'-3'-dideoxycytidine (ddC). These cases suggest that drug-induced cardiotoxicity may occur in a subgroup of HIV-infected patients treated with these structurally related nucleoside analogs.