Hypersensitivity to antiretroviral drugs

Eur Ann Allergy Clin Immunol. 2018 Nov;50(6):277-280. doi: 10.23822/EurAnnACI.1764-1489.42. Epub 2017 Nov 20.

Abstract

Background. Antiretroviral therapy (ART) may be responsible for hypersensitivity reactions varying in severity, clinical manifestations and frequency. Case report. We report the case of a 47-year-old woman with HIV infection who developed a delayed mucocutaneous reaction after treatment with ART. Hypersensitivty reaction (HR) to emtricitabine and tenofovir was considered probable based on positive patch tests (PT) and hypersensitivity reaction to nevirapine was confirmed by drug provocation test. Discussion. The diagnosis of HR to ART remains a diagnostic challenge, partly due to unknown mechanism and the absence of validated diagnostic tools. Patch testing may represent a useful method for confirming hypersensitivity. Further investigation in this area is required, so that successful management strategies can be offered, preventing loss of potent and viable antiretroviral agents.

Keywords: emtricitabine; hypersensitivity; nevirapine; patch tests; tenofovir.

Publication types

  • Case Reports

MeSH terms

  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / immunology*
  • Anti-HIV Agents / therapeutic use
  • Drug Hypersensitivity / diagnosis*
  • Drug Hypersensitivity / immunology*
  • Emtricitabine / adverse effects
  • Emtricitabine / immunology*
  • Emtricitabine / therapeutic use
  • Female
  • HIV Infections / drug therapy
  • Humans
  • Male
  • Middle Aged
  • Nevirapine / adverse effects
  • Nevirapine / immunology*
  • Nevirapine / therapeutic use
  • Skin Tests
  • Tenofovir / adverse effects
  • Tenofovir / immunology*
  • Tenofovir / therapeutic use

Substances

  • Anti-HIV Agents
  • Nevirapine
  • Tenofovir
  • Emtricitabine