Renal Atrophy Associated with Long-Term Treatment with Indinavir

Abstract

To the Editor: Indinavir, a human immunodeficiency virus (HIV)–protease inhibitor, improves survival in HIV-infected patients. Although urolithiasis and renal dysfunction are associated with short-term use of indinavir,1,2 no adverse effects have been reported in patients receiving long-term indinavir therapy. We describe two men with hemophilia in whom renal atrophy developed during long-term treatment with indinavir. The first patient was a 31-year-old, HIV-infected man with hemophilia who received treatment with zalcitabine (dideoxycytidine, 2.25 mg per day) and indinavir (2400 mg orally three times a day). The plasma HIV RNA level fell from 100,000 to less than 400 copies per milliliter; . . .