Drug hypersensitivity reactions in patients with HIV disease.

Hypersensitivity reactions to drugs used in HIV disease are common and clinically important, being responsible for a significant amount of morbidity and occasional mortality. The manifestations are typical of all drug hypersensitivity reactions, with the skin and liver being most commonly affected. Drug-specific T cells are increasingly being implicated in the pathogenesis of these reactions, which may, in the future, allow the development of better diagnostic strategies. Genetic factors predisposing to hypersensitivity reactions with antiretrovirals are also being increasingly identified - the prime example of this is with abacavir, where pre-prescription genotyping for HLA B*5701 has been shown to reduce the incidence of hypersensitivity. This avenue of research is destined to lead to better preventive strategies.