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The initiation of a tenofovir-based regimen is followed by a significant decline in eGFR, although it could be misinterpreted by the concomitant use of cotrimoxazole. A substantial proportion of patients develop AKI, but only a minority progress to CKD. Patients initiating HAART and developing AKI should be carefully monitored for progression of renal disease.

Statins are relatively safe first-line agents to use in the setting of dyslipidemia associated with immunosuppressive therapy in subjects undergoing liver transplantation, and also in HIV-infected patients with dyslipidemia due to antiretroviral drugs, especially ritonavir-boosted protease inhibitors. Rosuvastatin, a new statin, has demonstrated higher potency than previously released statins and is not extensively metabolized by the liver P450 system; therefore, the probability of deleterious pharmacokinetic interactions with commonly used immunosuppressants and antiretroviral drugs is reduced. We present the first case of severe rhabdomyolysis in a liver transplant patient receiving rosuvastatin for the treatment of immunosuppressive therapy-related grade IV dyslipidemia, an HIV-infected subject on protease inhibitor-sparing HAART, that resolved after rosuvastatin withdrawal, probably related to interactions between calcineurin inhibitors and hepatic rosuvastatin uptake transporters such as Organic Anion Transporting Polypeptides (OATPs). Liver Transpl 17:331-333, 2011. V C 2011 AASLD.Received September 22, 2010; accepted November 11, 2010. Dyslipidemia due to immunosuppressants (ISs) is common (45%-69%) after liver transplantation (LT) 1 and is also a frequent side effect of highly active antiretroviral therapy (HAART) in human immunodeficiency virus (HIV)-infected patients receiving ritonavir-boosted protease inhibitors (r-PIs). 2 In the setting of dyslipidemia after LT, statins are appropriate and well-tolerated first-line agents. 1 Rosuvastatin (ROS) is not extensively metabolized by cytochrome P450 3A4 (CYP3A4) and is more effective than pravastatin for the treatment of both low-density lipoprotein cholesterol and triglyceride levels in HIV1-infected subjects who have dyslipidemia and are receiving r-PIs. 3 The most serious adverse effects of statins are related to muscle injury and increases in liver enzymes in a dose-dependent manner. 4,5 However, the rates of creatine kinase (CK) elevations and myopathy (CK elevations >10 times the upper limit of normal), whether or

7‐11 November 2010, Tenth International Congress on Drug Therapy in HIV Infection, Glasgow, UK

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