Iatrogenic Cushing's Syndrome in an HIV-Infected Patient Treated with Inhaled Corticosteroids (Fluticasone Propionate) and Low Dose Ritonavir Enhanced PI Containing Regimen

Abstract In HIV-infected patients, ritonavir, a potent cytochrome P450 inhibitor, is increasingly used to improve the pharmacokinetic profile of the associated protease inhibitor. HIV physicians are often faced with potential drug–drug interaction while treating associated diseases. We report the case of an HIV-infected patient with clinical features of Cushing's syndrome due to the interaction of low dose ritonavir with inhaled fluticasone propionate (FP). Safety of life-long CYP450 inhibition has still to be demonstrated.