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- W2073345747 abstract "A 35-year-old Caucasian man presented with a rash after initiation of an atazanavir-based antiretroviral regimen (Fig. 1). He had been diagnosed HIV positive 5 years earlier and had previously been exposed to amprenavir, indinavir, lopinavir, ritonavir, lamivudine, zidovudine, stavudine and abacavir. The latter had been discontinued after a hypersensitivity reaction several years before. Because of persistent diarrhoea while on a stable twice-daily regimen of stavudine 40 mg, lamivudine 150 mg and lopinavir/ritonavir 3 capsules, the patient had been switched to atazanavir 300 mg/ritonavir 100 mg once daily 12 days before the present episode, which was characterized by a generalized, blanching, nonitchy, maculo-papular erythema, sparing his face, palms and soles. There was no mucosal involvement or fever. The patient had not taken any other drugs and no allergens could be identified. Serology results for common viral infections, including cytomegalovirus (CMV) infection, and for toxoplasmosis and syphilis excluded a recent infection. Liver function tests, inflammatory markers and safety parameters remained within the normal range. The Naranjo ADR Probability Scale [1] (score 6/13) indicated a probable relationship between the rash and atazanavir therapy. A skin biopsy was refused, and immunoglobulin E (IgE) levels were not measured. The rash subsided 2 days after the switch of atazanavir/ritonavir to lopinavir/ritonavir and administration of antihistamine drugs. Re-challenge with atazanavir was not performed because of the patient's previous history of severe drug hypersensitivity. He was subsequently given nevirapine and developed a mild, localized maculo-papular rash without liver involvement or physical impairment. Thus nevirapine was continued and the rash disappeared without treatment modification. Blanching, non-itchy, maculopapular erythema. Several antiretroviral drugs are known to cause skin eruptions. Atazanavir has not commonly been associated with the occurrence of a rash, [2,3] although it is listed as a possible side effect in the drug monograph [Reyataz (Atazanavir sulfate) capsules, Bristol-Myers Squibb Company, Princeton, NJ, USA, June 2005]. Physicians and patients should be aware of this potential complication. It remains unclear whether atazanavir should be discontinued in all cases or not." @default.
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- W2073345747 date "2005-10-28" @default.
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- W2073345747 title "Rash in an HIV-positive patient" @default.
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- W2073345747 doi "https://doi.org/10.1111/j.1468-1293.2005.00329.x" @default.
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