fluticasone and Sarcoma--Kaposi

This case report describes an exacerbation of AIDS-associated Kaposi sarcoma (KS) in the setting of iatrogenic Cushing syndrome caused by an interaction between ritonavir-boosted atazanavir and fluticasone. Discontinuation of fluticasone resulted in resolution of the cutaneous KS. Clinicians should be aware of this potential drug-drug interaction that can result in increased corticosteroid levels. Inhaled corticosteroids should be used cautiously in persons with HIV/AIDS who have a history of KS and are being treated with a boosted atazanavir regimen because this can potentially exacerbate KS.

Topics: Androstadienes; Anti-Inflammatory Agents; Atazanavir Sulfate; Cushing Syndrome; Drug Interactions; Fluticasone; HIV Infections; HIV Protease Inhibitors; Humans; Iatrogenic Disease; Male; Middle Aged; Oligopeptides; Pyridines; Ritonavir; Sarcoma, Kaposi