title: A severe hypersensitivity reaction to abacavir following re-challenge.
abstract: We report this case to highlight the possibility of a severe hypersensitivity reaction as an important potential consequence of couples, living with HIV, sharing anti-retroviral treatment. An HIV-1 positive and carrier of HLA-B*57:01 allele, treatment experienced man was commenced one pill Regimen Stribild (tenofovir, emtricitabine, elvitegravir and cobicistat) in July 2015. On running short of medication, he admitted to sharing his partner's treatment (Triumeq; abacavir, lamivudine and dolutegravir). On the second occasion, re-introduction resulted in whole body rash 4 h post dose and was associated with fever, respiratory symptoms, headache and vomiting. On examination, he was pyrexic, tachyponeic, tachycardiac and hypotensive. Hypersensitivity to abacavir can cause significant morbidity. Re-challenge can result in a more rapid, severe and potentially life-threatening reaction. This potentially could become an increasing problem with more couples, living with HIV, sharing medication.
authors.affiliation: Department of Genito-Urinary Medicine, Royal Victoria Hospital, Belfast, Northern Ireland, UK.
authors.forename: Sej
authors.initials: S
authors.lastname: Todd
authors.affiliation: Department of Genito-Urinary Medicine, Royal Victoria Hospital, Belfast, Northern Ireland, UK.
authors.forename: C R
authors.initials: CR
authors.lastname: Emerson
mesh_terms: D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015224:Dideoxynucleosides / Q000009:adverse effects* / Q000627:therapeutic use; D004338:Drug Combinations; D004342:Drug Hypersensitivity / Q000276:immunology*; D000069545:Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination / Q000627:therapeutic use; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology; D015497:HIV-1 / Q000276:immunology*; D015235:HLA-B Antigens / Q000235:genetics / Q000276:immunology*; D006575:Heterocyclic Compounds, 3-Ring / Q000627:therapeutic use; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D010078:Oxazines; D010879:Piperazines; D011728:Pyridones; D000099227:Abacavir; D000099226:Dolutegravir
chemical_list: D019380:Anti-HIV Agents; D015224:Dideoxynucleosides; D004338:Drug Combinations; D000069545:Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination; D015235:HLA-B Antigens; D006575:Heterocyclic Compounds, 3-Ring; D019259:Lamivudine; D010078:Oxazines; D010879:Piperazines; D011728:Pyridones; D000099227:Abacavir; D000099226:Dolutegravir; C484830:HLA-B*57:01 antigen
keywords: HIV; abacavir; hypersensitivity