Official websites use. Share sensitive information only on official, secure websites. Many drugs used for the treatment of HIV disease including the associated opportunistic infections can cause drug hypersensitivity reactions, which vary in severity, clinical manifestations and frequency.
These reactions are not only seen with the older compounds, but also with the newer more recently introduced drugs. The pathogenesis is unclear in most cases, but there is increasing evidence to support that many of these are mediated through a combination of immunologic and genetic factors through the major histocompatibility complex MHC. Testing before the prescription of abacavir has been shown to be of clinical utility, has resulted in a change in the drug label, is now recommended in clinical guidelines and is practiced in most Western countries.
For most other drugs, however, there are no good methods of prevention, and clinical monitoring with appropriate usually supportive and symptomatic treatment is required. There is a need to undertake further research in this area to increase our understanding of the mechanisms, which may lead to better preventive strategies through the development of predictive genetic biomarkers or through guiding the design of drugs less likely to cause these types of adverse drug reactions.
There are currently 22 antiretroviral drugs available in the UK which can be used in combinations of three or more drugs. There are currently six groups of agents comprising nucleoside reverse transcriptase inhibitors NRTIs , non nucleoside reverse transcriptase inhibitors NNRTIs , protease inhibitors PIs and three new groups, namely entry inhibitors fusion inhibitors and CCR5 inhibitors and integrase inhibitors Table 1.
However each of these drugs has a potential to cause serious adverse effects, including allergic reactions, as outlined in Table 2. The purpose of the article is to provide a succinct review of drug hypersensitivity associated with HAART, including the epidemiology, pathophysiology and management.
