[Drug reactions occur frequently in patients with HIV infection]

Three HIV-infected patients, men of 28 and 43 years old, and a woman of 32 years old, developed cutaneous reactions to one or more drugs prescribed to treat secondary infections. An increased incidence of hypersensitivity reactions to sulfonamides has been reported in literature. HIV-seropositive patients, however, appear to be prone to develop hypersensitivity reactions to many other drugs more often than HIV-seronegative patients. The underlying pathophysiological mechanism is not known. A possible explanation could be a virus-induced altered metabolism leading to an increased production of toxic reactive metabolites or inability either to conjugate these metabolites or to protect tissues against drug induced formation of reactive oxygen species, due to glutathione deficiency. Different serum IgE concentrations and enhanced histamine release of basophilic granulocytes have also been found in HIV-seropositive patients.