In this study, switching from stavudine to tenofovir maintained durable virologic suppression when the HAART regimen included a protease inhibitor or a non-nucleoside reverse transcriptase inhibitor, led to a slow improvement of lipoatrophy, and improved the lipid profile and lactate levels with excellent tolerability. These results support the proactive change of stavudine to tenofovir.

Reported here is an exceptional case of acute retroviral syndrome resembling septic shock that occurred in a chronic HIV-infected patient shortly following planned interruption of antiretroviral treatment. The therapeutic strategy, which is aimed at improving the immunological control of HIV infection, can therefore be deleterious in chronically infected patients and should be avoided outside of closely monitored clinical trials.