Approach to Rash in a Patient with HIV

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Abacavir HSR• Carriage of HLA-B*5701 alleleincreases risk of ABC HSR 1• However, incidence of ABC HSR is 0.8-3.4% in patients lacking HLA-B*5701allele 2• HSR worsens (fatal) if ABC continued1Mallal S et al. N Engl J Med 2008;358:5682 Post F., J Acquir Immune Defic Synd. 2010;55:49
Abacavir HSR• Most signs/symptoms resolve ≤48 hafter stopping ABC• Re-challenging patients with prior ABCHSR, results in life-threatening allergicreaction within hours• Prior to ABC use, patient should bescreened for HLA-B*5701 allele• Patients having HLA-B*5701 alleleshould be listed as allergic to ABC
Page 1 and 2: Approach to Rash in aPatient with H
Page 3 and 4: Discussion Topics• Causes & types
Page 5 and 6: Case 1• Put on Epzicom (abacavir/
Page 7 and 8: Skin Disorders Commonin HIV + Perso
Page 9 and 10: Cutaneous Drug Reactions:What Type
Page 11 and 12: Cutaneous Drug Reaction:Moderate Se
Page 13 and 14: Severe/Life-ThreateingCutaneous Dru
Page 15 and 16: Case 1 - Continued• Patient repor
Page 17 and 18: ARV drugs frequentlyassociated with
Page 19: Abacavir HSRFrom FDA-approved packa
Page 23 and 24: Darunavir• Rash, ~7%.• Most mil
Page 25 and 26: PhotodermatitisMaurer, TA. Topics H
Page 27 and 28: Eosinophilic FolliculitisMaurer TA
Page 29 and 30: Rashes Caused byInfections
Page 31 and 32: Secondary Syphilis
Page 33 and 34: Varicella-Zoster Virus (VZV)HIV Web
Page 35 and 36: What would be an appropriatenext st
Page 37 and 38: Cutaneous Drug Reaction:Patient Cou
Page 39 and 40: What do you recommend aboutfuture u
Page 41 and 42: What would be theappropriate next s
Page 43 and 44: Approach to EfavirenzRash• Usuall
Page 45 and 46: What would be theappropriate next s
Page 47 and 48: Patient BF
Page 49 and 50: Case 3: Continued• Seen by primar
Page 51 and 52: Patient BF’s Diagnosis:Neurosyphi
Page 53: Nevirapine Rash• More common in w

Approach to Rash in a Patient with HIV

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