Clinical Profile of Adverse Cutaneous Drug Reactions in Patients with Human Immunodeficiency Virus

Puteri Nabilah Maharani, Oki Suwarsa, Susantina Prodjosoewojo

Abstract


Background: Adverse cutaneous drug reactions (ACDRs) are common problems in patients during the treatment of various diseases. The clinical feature varies from mild manifestation such as morbilliform, urticaria, and contact dermatitis, to severe manifestation such as Stevens - Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN). Patients infected with the human immunodeficiency virus (HIV) have an increased risk of developing ACDRs due to immune system disruption. This study aimed to describe the clinical features of ACDRs in HIV patients and the drugs that cause ACDRs.

Method: This study was a retrospective study using secondary data from medical records of HIV patients with ACDRs who visited Teratai Clinic of Dr. Hasan Sadikin General Hospital Bandung from 2014 to 2018. Total sampling was applied and results were presented in percentage.

Results: There were 94 HIV patients with ACDRs out of 557 HIV patients. Adverse cutaneous drug reactions are commonly found in males aged 20-39 years old. The clinical features found were morbilliform (85.6%), SJS (8.9%), urticaria (4.4%), and erythroderma (1.1%). The most common drugs causing ACDRs were Cotrimoxazole (30%), Efavirenz (28.9%), and Nevirapine (16.7%).

Conclusion: The prevalence of ACDRs in HIV patients in this study is 16.9%. The most common clinical features are morbilli form and SJS with Cotrimoxazole, Efavirenz, and Nevirapine causing most of the ACDRs.


Keywords


Adverse cutaneous drug reactions; antiretroviral; drug hypersensitivity

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References


UNAIDS. UNAIDS data 2018. Geneva: UNAIDS; 2018. p.376

Abbas AK, Lichtman AH, Pillai S. Basic immunology: functions and disorders of the immune system. 5th ed. St. Louis: Elsevier; 2016

Kementerian Kesehatan Republik Indonesia. Pedoman nasional tatalaksana klinis infeksi HIV dan terapi antiretroviral pada orang dewasa. Jakarta: Kementerian Kesehatan RI; 2012.

Li YY, Jin YM, He LP, Bai JS, Liu J, Yu M, et al. Clinical analysis of HIV/AIDS patients with drug eruption in Yunnan, China. Sci Rep. 2016;6:35938.

Hughes CA, Tseng A, Cooper R. Managing drug interactions in HIV-infected adults with comorbid illness. CMAJ. 2015;187(1):36–43.

Pandapotan RA, Rengganis I. Approach to Diagnosis and Treatment of Drug Allergy. Jurnal Penyakit Dalam Indonesia. 2017;4(1):45–52.

Minhajat R, Djaharuddin I, Halim R, Benyamin AF, Bakri S. Drugs hypersensitivity reaction in patient with human immunodeficiency virus infection. J Allergy Ther. 2017;8(1):1000252.

Kim YJ, Woo JH, Kim MJ, Park DW, Song JY, Kim SW, et al. Opportunistic diseases among HIV-infected patients: a multicenter-nationwide Korean HIV/AIDS cohort study, 2006 to 2013. Korean J Intern Med. 2016;31(5):953–60.

Dewi ISL, Hidayati AF. Manifestation of skin disorders in HIV & AIDS patients. Berkala Ilmu Kesehatan Kulit dan Kelamin. 2015;27(2):97–105

Kouotou EA, Nansseu JR, Ngono VN, Tatah SA, Bissek ACZ, Ndam ECN, et al. Prevalence and clinical profile of drug eruptions among antiretroviral therapy-exposed HIV infected people in Yaoundé, Cameroon. Dermatology Research and Practice. 2017;2017(1):6216193.

Masenyetse LJ, Manda SOM, Mwambi HG. An assessment of adverse drug reactions among HIV positive patients receiving antiretroviral treatment in South Africa. AIDS Res Ther. 2015;12:6.

Armeinesya S, Rowawi R, Hamda ME. Manifestations of allergic drug eruption to antiretroviral in HIV/AIDS patients at Teratai Clinic Dr. Hasan Sadikin General Hospital. JSK. 2018;4(1):24–8.

Tesiman J, Sundaru H, Karjadi TH, Setiati S. Prevalence and predictors of atopy in HIV/AIDS patients. Jurnal Penyakit Dalam Indonesia. 2016;3(2):93–9.

Yang C, Mosam A, Mankahla A, Dlova N, Saavedra A. HIV infection predisposes skin to toxic epidermal necrolysis via depletion of skin-directed CD4+ T cells. J Am Acad Dermatology. 2014;70(6):1096–102.

Peter J, Choshi P, Lehloenya RJ. Drug hypersensitivity in HIV infection. Curr Opin Allergy Clin Immunol. 2019;19(4):272–82.

Usmani MH, Qureishi R, Patel R, Kumar PM. Clinical spectrum of opportunistic infections in HIV positive patients. J Evol Med Dent Sci. 2015;4(24):4076–85.

Yunihastuti E, Widhani A, Karjadi TH. Drug hypersensitivity in human immunodeficiency virus-infected patient: challenging diagnosis and management. Asia Pac Allergy. 2014;4(1):54–67.

Kementerian Kesehatan RI. Current status of integrated community based TB service delivery and the Global Fund work plan to find missing TB cases. Jakarta: Kementerian Kesehatan RI; 2017.

Pavlos R, Mckinnon EJ, Ostrov DA, Peters B, Buus S, Koelle D, et al. Shared peptide binding of HLA Class I and II alleles associate with cutaneous nevirapine hypersensitivity and identify novel risk alleles. Sci Rep. 2017;7(1):8653.

Mittmann N, Knowles SR, Koo M, Shear NH, Rachlis A, Rourke SB. Incidence of toxic epidermal necrolysis and Stevens-Johnson Syndrome in an HIV Cohort: an obseravtional, retrospective case series study. Am J Clin Dermatol. 2012;13(1):49–54.




DOI: https://doi.org/10.15850/amj.v7n4.1955

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