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Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors
Published on: April 9, 2014
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Drug hypersensitivity in HIV infection
Jonny Peter1,2,3, Phuti Choshi1,2, Rannakoe J Lehloenya3,4
1Division of Allergy and Clinical Immunology, Department of Medicine, University of Cape Town.
Current Opinion in Allergy and Clinical Immunology
|May 31, 2019
Summary
Immune-mediated adverse drug reactions (IM-ADRs) are more common in people with HIV. New strategies are needed for prevention and management due to complex factors like polypharmacy and drug interactions.
Area of Science:
- Pharmacology
- Immunology
- Infectious Diseases
Background:
- Immune-mediated adverse drug reactions (IM-ADRs) are significantly more prevalent in individuals with HIV.
- Antiretrovirals and anti-infectives are common culprits, but specific drug burdens vary by population and evolving treatment landscapes.
Purpose of the Study:
- To review recent literature on the epidemiology, mechanisms, clinical management, and prevention of IM-ADRs in people living with HIV/AIDS.
- To highlight challenges and potential solutions for managing drug reactions in this vulnerable population.
Main Methods:
- Literature review of recent studies on IM-ADRs in HIV-infected populations.
- Analysis of epidemiological data, clinical presentations, and management strategies.
- Examination of prevention strategies, including genetic screening and desensitization.
Main Results:
- High rates of delayed hypersensitivity reactions persist, with new reports involving integrase strand transfer inhibitors.
- Clinical management is largely similar to HIV-uninfected individuals, with notable exceptions like efavirenz-induced liver injury.
- Successful prevention of Abacavir hypersensitivity through HLA-B57:01 screening demonstrates the potential of mechanism-guided interventions.
Conclusions:
- IM-ADRs present ongoing challenges in HIV management due to polypharmacy, drug interactions, and patient vulnerability.
- Enhanced diagnostics, predictive biomarkers, and advanced strategies like drug provocation testing and desensitization are crucial.
- Further research is needed to improve prevention and guide treatment decisions for IM-ADRs in people with HIV.
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