Volume 121, Issue 4 , Pages 826-832.e5, April 2008
Diagnosis and management of HIV drug hypersensitivity
Drug hypersensitivity reactions are an important cause of morbidity in HIV-infected patients who take complex medication regimens. Correct diagnosis and management of these reactions are essential in the clinical care of HIV disease. Trimethoprim-sulfamethoxazole, abacavir, nevirapine, atazanavir, and enfuvirtide can all cause hypersensitivity rashes. In this review, we discuss the evidence for immunologic mechanisms of hypersensitivity reactions to HIV medications, the clinical characteristics of these reactions, and guidelines that currently exist for their identification and management.
Key words: Human immunodeficiency virus, drug hypersensitivity, trimethoprim-sulfamethoxazole, antiretroviral agents, protease inhibitor, fusion inhibitor, integrase inhibitor
Abbreviations used: PI, Protease inhibitor, SJS, Stevens-Johnson syndrome, TEN, Toxic epidermal necrolysis, TMP-SMX, Trimethoprim-sulfamethoxazole
Supported by National Institutes of Health grants AI27551, AI36211, A169441, HD41983, RR0188, HD79533, HL72705, and HD78522; and the David Fund, Pediatrics AIDS Fund, and Immunology Research Fund, Texas Children's Hospital.
The content of this article was presented by W. T. Shearer as a part of the Symposium 4303 at the American Academy of Allergy, Asthma & Immunology Annual Meeting 2007 entitled HIV/AIDS: An Update for the Allergist/Immunologist; Pharmacotherapy of HIV/AIDS and Diagnosis and Management of Drug and Other Hypersensitivity Phenomena.
Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.
PII: S0091-6749(07)01964-1
doi:10.1016/j.jaci.2007.10.021
© 2008 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
Volume 121, Issue 4 , Pages 826-832.e5, April 2008
