Human Immunodeficiency Virus Book

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Drug Reaction in HIV

Aka: Drug Reaction in HIV, Hypersensitivity and Pruritic Syndrome
  1. Mechanism
    1. Increased incidence Hypersensitivity cutaneous reaction
  2. Etiology: Medication Reaction
    1. NNRTI's (especially Nevirapine)
    2. Abacavir (Ziagen)
      1. nRTI with life-threatening Hypersensitivity Reaction
    3. Sulfa
    4. Dapsone
  3. Differential Diagnosis
    1. See HIV Related Rash
  4. 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
  5. 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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