Prospective evaluation of risk factors of cutaneous drug reactions to sulfonamides in patients with AIDS - 01/09/11

Doi : 10.1067/mjd.2002.120468

Muriel Eliaszewicz, MD^a, Antoine Flahault, MD, PhD^d, Jean-Claude Roujeau, MD^k, Anne Marie Fillet, MD, PhD^e, Dominique Challine, MD, PhD^f, Samira Mansouri, MDⁱ, Pierre Wolkenstein, MD, PhD^k, Sélim Aractingi, MD, PhDⁱ, Dominique Penso-Assathiany, MD^g, Caroline Maslo, MD, PhD^c, Isabelle Bourgault-Villada, MD, PhD^j, Olivier Chosidow, MD, PhD^h, Eric Caumes, MD^b
Epitox Study Group^*
Paris, Créteil, and Boulogne, France
From the Departments of Infectious Diseases, Hôpital de l'Institut Pasteur, Paris,^a Hôpital de la Pitiè-Salpétrière, Paris,^b Hôpital Rotschild, Paris,^c the Department of Biostatistics, Hôpital Tenon, Paris,^d the Departments of Virology, Hôpital de la Pitié-Salpétrière, Paris,^e Hôpital Henri Mondor, Créteil,^f the Departments of Internal Medicine, Hôpital Bicêtre, Le Kremlin-Bicêtre,^g Hôpital de la Pitiè-Salpétrière, Paris,^h the Departments of Dermatology, Hôpital Tenon, Paris,ⁱ Hôpital Ambroise Paré, Boulogne,^j and Hôpital Henri Mondor, Créteil.^k

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. (J Am Acad Dermatol 2002;47:40-6.)

Le texte complet de cet article est disponible en PDF.

Abbreviations : ADR, CMV, EBV, HAART, HHV, OR, PCP, PCR, PYR, SDZ, SMX, TMP

Plan

Methods

Design of the study

Patients

Definition of drug eruption

	Funding sources: Grants from Fondation pour la Recherche Médicale (SIDACTION 1994), Délégation à la Recherche Clinique de l'Assistance Publique-Hôpitaux de Paris (EMUL 940703), Agence Française de Sécurité Sanitaire des Produits de Santé, Smith Kline Beecham Laboratories, Roche Laboratories, and Glaxo-Wellcome Laboratories.
	Conflict of interest: None.
	Reprint requests: Eric Caumes, MD, Service des maladies infectieuses et tropicales, Hôpital de la Pitié Salpétrière, 47-83, boulevard de l'hôpital, 75013 Paris, France.
	^*A listing of the investigators can be found at the end of the article.

Export

Vol 47 - N° 1

P. 40-46 - juillet 2002 Retour au numéro

Article précédent

The persistent risk of genital tumors among men treated with psoralen plus ultraviolet A (PUVA) for psoriasis
Robert S. Stern, Sepideh Bagheri, Khanh Nichols, PUVA Follow Up Study*

| Article suivant

Paraneoplastic acral vascular syndrome: Epidemiologic features, clinical manifestations, and disease sequelae
Ewa Poszepczynska-Guigné, Manuelle Viguier, Olivier Chosidow, Brigitte Orcel, Joseph Emmerich, Louis Dubertret

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

Déjà abonné à cette revue ?

connectez-vous ou créez un compte

Prospective evaluation of risk factors of cutaneous drug reactions to sulfonamides in patients with AIDS - 01/09/11

Abstract

Plan

Export citations

Fichier

Contenu

Accès rapides

Mon compte

Aide & support

Plateformes Elsevier Masson

Déclaration CNIL