ABSTRACT
Drug hypersensitivity reactions in the HIV-positive patient are a major problem in management of these patients and, nowadays the antiretroviral agents are the main cause of those reactions, exceeding cotrimoxazole. The present review focuses on immunologic reactions that have been reported associated with antiretroviral agents. We have reviewed case reports on Medline(R) to September 2005. Evidence that these reactions are immune mediated is largely based on the typical symptomatology and few studies have been done to determine the pathogenesis mechanisms. The clinical management of this type of reactions is complex because of differential diagnosis and of potential severity. It is essential that research is now carried out into the pathogenic mechanisms and so, we shall be able to offer an efficacious protocol to manage these situations.
Subject(s)
Anti-HIV Agents/adverse effects , Drug Hypersensitivity/etiology , HIV Infections/drug therapy , AIDS-Related Opportunistic Infections/diagnosis , Anti-HIV Agents/immunology , Anti-HIV Agents/therapeutic use , Diagnosis, Differential , Disease Management , Drug Eruptions/diagnosis , Drug Eruptions/etiology , Drug Hypersensitivity/diagnosis , Drug Hypersensitivity/physiopathology , HIV Fusion Inhibitors/adverse effects , HIV Fusion Inhibitors/immunology , HIV Fusion Inhibitors/therapeutic use , HIV Infections/immunology , HIV Protease Inhibitors/adverse effects , HIV Protease Inhibitors/immunology , HIV Protease Inhibitors/therapeutic use , Humans , Reverse Transcriptase Inhibitors/adverse effects , Reverse Transcriptase Inhibitors/classification , Reverse Transcriptase Inhibitors/immunology , Reverse Transcriptase Inhibitors/therapeutic useABSTRACT
Las reacciones de hipersensibilidad a fármacos en pacientes infectados por el virus de la inmunodeficiencia humana constituyen un importante problema en el manejo de este colectivo. En la actualidad las relacionadas con los antirretrovirales superan a las del cotrimoxazol. El objetivo de esta revisión fue recopilar lo publicado sobre reacciones adversas a antirretrovirales de presumible origen inmunológico. Para ello, se realizó una búsqueda bibliográfica en la base de datos Medline® hasta septiembre de 2005. La naturaleza inmunitaria de estas reacciones se presupone por las características clínicas y existen pocos estudios que analicen su fisiopatología y definan los mecanismos inmunológicos implicados. El manejo clínico de estas reacciones es complejo, fundamentalmente en relación con su diagnóstico diferencial y su potencial gravedad. Es necesario concentrar los esfuerzos investigadores para dilucidar los mecanismos patogénicos subyacentes y así poder ofertar estrategias de manejo a los clínicos que se enfrentan a estas situaciones
Drug hypersensitivity reactions in the HIV-positive patient are a major problem in management of these patients and, nowadays the antiretroviral agents are the main cause of those reactions, overcoming to cotrimoxazole. The present review focuses on immunologic reactions that have been reported associated with antiretroviral agents. We have reviewed case reports on Medline® to September 2005. Evidence that these reactions are immune mediated is largely based on the typical symptomatology and few studies have been done to determine the pathogenesis mechanisms. The clinical management of this type of reactions is complex because of differential diagnosis and of potential severity. It is essential that research is now carried out into the pathogenic mechanisms and so, we shall be able to offer an efficacious protocol to manage these situations
