Prospective evaluation of risk factors of cutaneous drug reactions to sulfonamides in patients with AIDS.
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.
Eliaszewicz
Muriel
M
Department of Infectious Diseases, Hôpital de l'Institut Pasteur, Paris, France.
Flahault
Antoine
A
Roujeau
Jean-Claude
JC
Fillet
Anne Marie
AM
Challine
Dominique
D
Mansouri
Samira
S
Wolkenstein
Pierre
P
Aractingi
Sélim
S
Penso-Assathiany
Dominique
D
Maslo
Caroline
C
Bourgault-Villada
Isabelle
I
Chosidow
Olivier
O
Caumes
Eric
E
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy*; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D015897:Comorbidity; D003875:Drug Eruptions / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D015999:Multivariate Analysis; D011020:Pneumonia, Pneumocystis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D011336:Probability; D011446:Prospective Studies; D012307:Risk Factors; D013449:Sulfonamides / Q000009:adverse effects* / Q000627:therapeutic use; D014123:Toxoplasmosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D014777:Virus Diseases / Q000453:epidemiology
D013449:Sulfonamides