Minocycline- and Tetracycline-Induced Hypertriglyceridemia in an HIV-Seropositive Patient Receiving Combination Antiretroviral Therapy

Abstract

Background: Acne vulgaris may occur as part of immune reconstitution in human immunodeficiency virus (HIV)-seropositive patients on highly active antiretroviral therapy (HAART). Tetracyclines are a common acne treatment. Hypertriglyceridemia has not been reported as a side effect of this drug class. Objective: We report a case of an HIV-seropositive man on HAART (CD4 count 450 cells/μL) who developed isolated hypertriglyceridemia (> 13 mmol/L) after three separate challenges with minocycline or tetracycline, improving each time therapy was discontinued. Results: Based on a review of the literature, this is the first reported case of hypertriglyceridemia with minocycline or tetracycline therapy. No published reports have examined the safety of tetracyclines in the setting of HIV or HAART. Conclusion: A strong temporal association between tetracycline use and hypertriglyceridemia was found without an alternate explanation for the observed lipid profile. Given the common use of tetracyclines in dermatology, we feel that this is an important observation to report.