Sousa M J, Cadinha S, Mota M, Teixeira T, Malheiro D, Moreira da Silva J P
Immunoallergology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
Infectious Diseases, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
Eur Ann Allergy Clin Immunol. 2018 Nov;50(6):277-280. doi: 10.23822/EurAnnACI.1764-1489.42. Epub 2017 Nov 20.
Antiretroviral therapy (ART) may be responsible for hypersensitivity reactions varying in severity, clinical manifestations and frequency. We report the case of a 47-year-old woman with HIV infection who developed a delayed mucocutaneous reaction after treatment with ART. Hypersensitivty reaction (HR) to emtricitabine and tenofovir was considered probable based on positive patch tests (PT) and hypersensitivity reaction to nevirapine was confirmed by drug provocation test. The diagnosis of HR to ART remains a diagnostic challenge, partly due to unknown mechanism and the absence of validated diagnostic tools. Patch testing may represent a useful method for confirming hypersensitivity. Further investigation in this area is required, so that successful management strategies can be offered, preventing loss of potent and viable antiretroviral agents.
抗逆转录病毒疗法(ART)可能导致严重程度、临床表现和发生频率各异的过敏反应。我们报告一例47岁感染HIV的女性病例,该患者在接受ART治疗后出现了迟发性黏膜皮肤反应。基于斑贴试验(PT)阳性,考虑对恩曲他滨和替诺福韦的过敏反应(HR)可能性较大,通过药物激发试验确诊了对奈韦拉平的过敏反应。ART相关HR的诊断仍然是一项诊断挑战,部分原因是机制不明且缺乏经过验证的诊断工具。斑贴试验可能是确认过敏反应的一种有用方法。需要对此领域进行进一步研究,以便提供成功的管理策略,防止强效且可行的抗逆转录病毒药物流失。