[Raltegravir in a special case: patient with HIV and Burkitt's lymphoma].

HISTORY AND CLINICAL FINDINGS: A 38-year-old HIV positive man suffered from right upper abdominal pain and oesophageal reflux syndromes. He was in a good general state of health and nutrition with no concomitant symptoms.

INVESTIGATIONS: A small bowel tumor and slight soor esophagitis had been diagnosed by esophago-gastroduodenoscopy. The tumor was histologically classified as Burkitt?s lymphoma.

TREATMENT AND OUTCOME: The patient received 6 cycles of chemotherapy according to the B-ALL protocol, and antiretroviral therapy with lamivudine (300 mg), abacavir (600 mg) und raltegravir (2 × 400 mg) was initiated immediately. After the first cycle of chemotherapy a complete remission of Burkitt?s lymphoma was achieved. Laboratory parameters recovered after completion of 6 cycles to a value of 400 CD4-positive lymphocytes/mm (3) with a viral load of HIV-1-RNA 20 - 300 copies/ml in plasma.

CONCLUSION: Immediate initiation of antiretroviral therapy is essential after the diagnosis of AIDS-defining symptoms. The choice of an appropriate treatment regimen is a critical factor in order to avoid toxic drug interactions and adverse events while maintaining a highly effective treatment.