Overdose of elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide in an HIV-1-infected subject with attempted suicide

Infection. 2019 Feb;47(1):115-119. doi: 10.1007/s15010-018-1201-x. Epub 2018 Aug 25.

Abstract

Introduction: Data are lacking regarding overdose of Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide (E/C/F/TAF).

Material and methods: We present the first report of suicidal attempt with E/C/F/TAF in a Human Immunodeficiency Virus-infected subject.

Results: A reversible acute renal failure with no proximal tubulopathy and neuropsychiatric issues are discussed. E/C/F/TAF withdrawal resulted in favourable renal and neuropsychiatric outcomes. The suicide attempt seemed unrelated to the integrase strand transfer inhibitor, being evenly explained within the context of stressful personal conflicts.

Conclusion: A suicidal attempt with an E/C/F/TAF overdose in an HIV-infected patient, resulted in a favourable outcome from a renal and neuropsychiatric standpoint.

Keywords: Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; Overdose; Suicide attempt.

Publication types

  • Case Reports

MeSH terms

  • Adenine / administration & dosage
  • Adenine / adverse effects
  • Adenine / analogs & derivatives
  • Alanine
  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / adverse effects*
  • Cobicistat / administration & dosage
  • Cobicistat / adverse effects
  • Drug Combinations
  • Drug Overdose / complications
  • Drug Overdose / diagnosis*
  • Emtricitabine / administration & dosage
  • Emtricitabine / adverse effects
  • HIV Infections / drug therapy*
  • Humans
  • Male
  • Middle Aged
  • Quinolones / administration & dosage
  • Quinolones / adverse effects
  • Renal Insufficiency / chemically induced
  • Renal Insufficiency / physiopathology*
  • Suicide, Attempted*
  • Tenofovir / analogs & derivatives

Substances

  • Anti-HIV Agents
  • Drug Combinations
  • Quinolones
  • elvitegravir
  • Tenofovir
  • tenofovir alafenamide
  • Emtricitabine
  • Adenine
  • Cobicistat
  • Alanine