Drug Reaction in HIV

Aka: Drug Reaction in HIV, Hypersensitivity and Pruritic Syndrome

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II. Mechanism

  1. Increased incidence Hypersensitivity cutaneous reaction

III. Etiology: Medication Reaction

  1. NNRTI's (especially Nevirapine)
  2. Abacavir (Ziagen)
    1. nRTI with life-threatening Hypersensitivity Reaction
  3. Sulfa
  4. Dapsone

IV. Differential Diagnosis

  1. See HIV Related Rash

V. Signs

  1. Mild-Moderate reactions
    1. Maculopapular eruptions
    2. Urticaria
    3. Fixed Drug Eruptions
  2. Severe reactions
    1. Exfoliative Erythroderma
    2. Erythema Multiforme
    3. Stevens-Johnson Syndrome

VI. Management

  1. Not usually necessary to discontinue offending drug
    1. Spontaneous resolution in 70-80% cases in 7-10 days
    2. Serious reactions require drug discontinuation
  2. Antipruritics
  3. Antipyretics

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