Prospective evaluation of risk factors of cutaneous drug reactions to sulfonamides in patients with AIDS

J Am Acad Dermatol. 2002 Jul;47(1):40-6. doi: 10.1067/mjd.2002.120468.

Abstract

Background: Persons with HIV infection have increased rates of drug eruptions.

Objective: Our aim was to evaluate the risk factors of drug eruptions in response to sulfonamides in patients with AIDS, using a case-control analysis.

Methods: One hundred thirty-six patients who were hospitalized for pneumocystosis or toxoplasmosis were evaluated at the onset of treatment for various risk factors, which were then compared among patients with (48, 36%) and without (88, 64%) a drug eruption.

Results: In multivariate analysis, high CD8(+) cell count and age less than 36 years indicated a risk of drug eruption (respective odds ratios: 3.5 [95% CI 1.6-7.8], P =.002, and 2.1 [95% CI 1-4.6], P =.06). Markers of viral replication for HIV, Epstein-Barr virus, cytomegalovirus, human herpesvirus 6, and parvovirus B19, slow acetylation phenotype or genotype, and glutathione level were not associated with a risk. Administration of corticosteroids had no preventive effect.

Conclusions: Our results challenge several current concepts regarding drug eruptions by discarding a strong association with glutathione deficiency, slow acetylation, or active viral infections and by showing no preventive effect of corticosteroids.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / diagnosis
  • AIDS-Related Opportunistic Infections / drug therapy*
  • Adolescent
  • Adult
  • Analysis of Variance
  • Case-Control Studies
  • Comorbidity
  • Drug Eruptions / diagnosis
  • Drug Eruptions / epidemiology*
  • Drug Eruptions / etiology*
  • Female
  • Humans
  • Incidence
  • Male
  • Multivariate Analysis
  • Pneumonia, Pneumocystis / diagnosis
  • Pneumonia, Pneumocystis / drug therapy
  • Pneumonia, Pneumocystis / epidemiology
  • Probability
  • Prospective Studies
  • Risk Factors
  • Sulfonamides / adverse effects*
  • Sulfonamides / therapeutic use
  • Toxoplasmosis / diagnosis
  • Toxoplasmosis / drug therapy
  • Toxoplasmosis / epidemiology
  • Virus Diseases / epidemiology

Substances

  • Sulfonamides