Acute rhabdomyolysis in a woman living with HIV - antiretroviral treatment is not always to blame.

We report a 49-year-old woman living with HIV who stopped her antiretroviral treatment for several weeks. One month after resuming treatment with dolutegravir and lamivudine (Dovato®), she presented with myalgia, physical weakness and rhabdomyolysis. As we suspected a drug-related cause, Dovato® was changed for tenofovir disoproxil fumarate, lamivudine and doravirine (Delstrigo®) without improvement. Second line assessment led to a diagnosis of dermatomyositis, with presence of anti-Mi-2 antibodies, typical MRI findings and pathological analysis of muscle biopsy. The outcome was favorable after treatment with corticosteroids followed by methotrexate. Dovato® was subsequently re-prescribed without recurrence of symptoms or rhabdomyolysis.