Drug Rash With Eosinophilia and Systemic Symptoms Syndrome and Renal Toxicity With a Nevirapine-Containing Regimen in a Pregnant Patient With Human Immunodeficiency Virus

2003 ◽  
Vol 101 (Supplement) ◽  
pp. 1094-1097
Author(s):  
Eric Knudtson ◽  
Michael Para ◽  
Hillary Boswell ◽  
Patty Fan-Havard
Keyword(s):  
Human Immunodeficiency Virus ◽  
Renal Toxicity ◽  
Pregnant Patient ◽  
Immunodeficiency Virus ◽  
Drug Rash ◽  
Systemic Symptoms

scholarly journals Therapeutic Trial of Rifabutin After Rifampicin-Associated DRESS Syndrome in Tuberculosis-Human Immunodeficiency Virus Coinfected Patients

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Rannakoe J. Lehloenya ◽  
Sipho Dlamini ◽  
Rudzani Muloiwa ◽  
Betty Kakande ◽  
Mzudumile R. Ngwanya ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Clinical Management ◽  
Cross Reactivity ◽  
Therapeutic Trial ◽  
Drug Reactions ◽  
Dress Syndrome ◽  
Drug Eruptions ◽  
Immunodeficiency Virus ◽  
Drug Rash ◽  
Systemic Symptoms

Abstract Elimination of a rifamycin from the treatment regimen for tuberculosis negatively impacts outcomes. Cross-reactivity between the rifamycins after drug eruptions is unclear. We report 6 consecutive human immunodeficiency virus-infected patients with rifampicin-associated drug rash with eosinophilia and systemic symptoms (DRESS) syndrome confirmed on diagnostic rechallenge. The patients subsequently tolerated rifabutin. These data inform clinical management of tuberculosis-associated drug reactions.

Toxic Epidermal Necrolysis Seen in a Human Immunodeficiency Virus Positive Pregnant Patient

2015 ◽  
Vol 2 (2) ◽  
pp. 100
Author(s):  
HajaratuU Sulayman ◽  
WanonyiI Kwala ◽  
ZakariY Aliyu ◽  
RamadanA. S. Attia ◽  
MuhammadM Bushi
Keyword(s):  
Human Immunodeficiency Virus ◽  
Toxic Epidermal Necrolysis ◽  
Pregnant Patient ◽  
Immunodeficiency Virus

scholarly journals Indinavir Pharmacokinetics and Parmacodynamics in Children with Human Immunodeficiency Virus Infection

2000 ◽  
Vol 44 (3) ◽  
pp. 752-755 ◽  
Author(s):  
Giorgio Gatti ◽  
Alessandra Vigano' ◽  
Natascia Sala ◽  
Stefano Vella ◽  
Matteo Bassetti ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Dosage Regimen ◽  
Renal Toxicity ◽  
Significant Negative Correlation ◽  
Pharmacokinetic Parameters ◽  
Pharmacokinetic Data ◽  
Time Curve ◽  
Number Of Patients ◽  
Immunodeficiency Virus ◽  
The Difference

ABSTRACT The indinavir dosage regimen currently used for human immunodeficiency virus (HIV)-infected children is not based on pharmacokinetic data obtained in the target patient population. The purpose of our study was to characterize indinavir pharmacokinetics and pharmacodynamics in HIV-infected children. Eleven children (age range, 9.0 to 13.6 years; weight range, 21.7 to 56.0 kg) receiving indinavir (500 mg/m2 every 8 h) in combination with lamivudine and stavudine were studied. The correlation of indinavir pharmacokinetic parameters and demographic parameters was evaluated. Also, the pharmacodynamic relationship between parameters of indinavir exposure and parameters of renal toxicity and immunologic recovery was studied. The area under the indinavir concentration-time curve (AUC) and patient body surface area (BSA) showed a significant negative correlation (r = 0.73; P = 0.012). Patients with smaller BSA had excessive indinavir AUC compared to adults. On the other hand, the median minimum drug concentration in plasma (C min) was lower than that reported for adults. The maximum indinavir concentration in serum was higher in patients with renal toxicity (5 out of 11 children), but the difference was not statistically significant (15.3 ± 8.2 versus 9.8 ± 4.4 mg/liter; P = 0.19). There was a trend toward higher immunologic efficacy in patients with greater indinavir exposure: the time-averaged AUC of the percentage of CD4+ lymphocytes over the baseline value for patients with indinavir C min > 95% inhibitory concentration (IC95) was higher than in patients withC min < IC95(P = 0.068). Our study suggests that a dose reduction may be appropriate for children with small BSA and that a 6-h dosage regimen may be indicated for a substantial percentage of patients. Due to the low number of patients enrolled in this study, our results should be confirmed by a larger study.

Dolutegravir as a trigger for DRESS syndrome?

2018 ◽  
Vol 29 (10) ◽  
pp. 1036-1038 ◽  
Author(s):  
Charlotte Martin ◽  
Marie-Christine Payen ◽  
Stephane De Wit
Keyword(s):  
Human Immunodeficiency Virus ◽  
Drug Reaction ◽  
Second Generation ◽  
Strand Transfer ◽  
Dress Syndrome ◽  
Immunodeficiency Virus ◽  
Transfer Inhibitor ◽  
Inhibitor Drug ◽  
Systemic Symptoms ◽  
Integrase Strand Transfer Inhibitor

Dolutegravir is an increasingly-used second-generation human immunodeficiency virus integrase strand transfer inhibitor. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome has been described in several patients treated with raltegravir but to our knowledge, there is no previous report of DRESS syndrome associated with dolutegravir.

scholarly journals Mycobacterium avium Complex Osteomyelitis in Persons With Human Immunodeficiency Virus: Case Series and Literature Review

2015 ◽  
Vol 2 (3) ◽  
Author(s):  
Brian R. Wood ◽  
Martha O. Buitrago ◽  
Sugat Patel ◽  
David H. Hachey ◽  
Sebastien Haneuse ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Literature Review ◽  
Mycobacterium Avium ◽  
Mycobacterium Avium Complex ◽  
Case Series ◽  
Cd4 Counts ◽  
Immunodeficiency Virus ◽  
Systemic Symptoms ◽  
Disseminated Disease

Abstract In persons with advanced immunosuppression, Mycobacterium avium complex (MAC) typically causes disseminated disease with systemic symptoms. We report 2 cases in which MAC caused localized osteomyelitis in human immunodeficiency virus (HIV)-infected individuals on antiretroviral therapy with rising CD4 counts. We summarize 17 additional cases of HIV-associated MAC osteomyelitis from the literature and compare CD4 count at presentation for vertebral cases versus nonvertebral cases, which reveals a significantly higher CD4 at presentation for vertebral cases (median 251 cells/µL vs 50 cells/µL; P = .043; Mann–Whitney U test). The literature review demonstrates that the majority of cases of MAC osteomyelitis, especially vertebral, occurs in individuals with CD4 counts that have increased to above 100 cells/µL on antiretroviral therapy. Among HIV-infected individuals with osteomyelitis, MAC should be considered a possible etiology, particularly in the setting of immune reconstitution.

scholarly journals Anticytomegaloviral activity and safety of cidofovir in patients with human immunodeficiency virus infection and cytomegalovirus viruria.

1995 ◽  
Vol 39 (4) ◽  
pp. 882-886 ◽  
Author(s):  
M A Polis ◽  
K M Spooner ◽  
B F Baird ◽  
J F Manischewitz ◽  
H S Jaffe ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Renal Toxicity ◽  
Concurrent Administration ◽  
Efficacy Trials ◽  
Optimal Dosing ◽  
Immunodeficiency Virus ◽  
Dose Ranging ◽  
Cmv Disease ◽  
To Receive

Cidofovir (HPMPC; (S)-1-[3-hydroxy-2-(phosphonylmethoxy)propyl]cytosine) is a nucleotide analog with activity against human cytomegalovirus (CMV). A phase I/II dose escalation trial was conducted with asymptomatic human immunodeficiency virus (HIV)-infected patients with CMV viruria to determine its pharmacokinetics, maximally tolerated dose, and preliminary antiviral activity against CMV. Qualitative CMV blood and urine cultures were monitored weekly to assess anti-CMV activity. Twenty-one HIV-infected persons with CD4 counts from 0 to 389 cells per microliters (median, 39) were enrolled in six dose-ranging groups. The first five groups enrolled four patients each to receive cidofovir infusions either weekly or biweekly for 4 weeks or every 3 weeks for 12 weeks. The sixth group enrolled one patient who received infusions of 5 mg/kg of body weight every other week. Patients receiving 0.5 or 1.5 mg/kg twice weekly experienced no serious toxicity. The first two patients who received 5 mg/kg twice weekly developed glycosuria and 2+ proteinuria. Subsequent patients received concomitant probenecid to attempt to ameliorate renal toxicity. Seventeen patients experienced proteinuria on one or more occasions; 6 of them experienced at least 2+ proteinuria. Four patients did not complete the study as planned because of renal toxicity. Positive CMV urine cultures reverted to negative in 2 of 8 patients receiving doses of < or = 1.5 mg/kg twice weekly and 11 of 13 patients receiving higher doses. Cidofovir has in vivo anti-CMV activity demonstrated by prolonged clearing of CMV viruria, although this observation is tempered by the fact that clearance of viremia could not be demonstrated. The dose-limiting toxicity is renal; however, concurrent administration of probenecid may be protective. The maximally tolerated weekly intravenous dose with probenecid is approximately 5 mg/kg. Efficacy trials with CMV disease will define the therapeutic utility and optimal dosing interval for cidofovir.

scholarly journals A case of a drug reaction to sulfasalazine in a patient infected with HIV

2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Leanne Swart ◽  
Elise Schapkaitz ◽  
Anima Baiden
Keyword(s):  
Rheumatoid Arthritis ◽  
Human Immunodeficiency Virus ◽  
Drug Reaction ◽  
Supportive Treatment ◽  
Drug Reactions ◽  
Infected Female ◽  
Immunodeficiency Virus ◽  
Systemic Symptoms ◽  
Multiple Drugs ◽  
Made In

Introduction: The diagnosis of drug reaction with eosinophilia and systemic symptoms (DRESS) in human immunodeficiency virus (HIV) patients on multiple drugs with concomitant disorders presents a diagnostic challenge.Patient presentation: We describe a case of a drug reaction to sulfasalazine in a 46 year old HIV-infected female with concurrent rheumatoid arthritis which presented atypically with a marked peripheral blood plasmacytosis mimicking a lymphoproliferative neoplasm.Management and outcome: A diagnosis of DRESS was made in conjunction with the laboratory and clinical presenting findings. Sulfasalazine was immediately discontinued. The mucocutaneous rash and systemic symptoms (which included fever, lymphadenopathy and multi-organ dysfunction) resolved with supportive treatment. This included topical and systemic corticosteroids.Conclusion: In conclusion, it is important to consider drug reactions when evaluating patients infected with HIV.

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