Clinical Profile of Cutaneous Adverse Drug Reactions in HIV Patients: A Cross-sectional Study
Published: May 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/61197.17838
Seethalakshmi Ganga Vellaisamy, Minushwetha Masilamani, Divyasri Thangamuthu, Kannan Gopalan, N Kumarasamy
1. Professor, Department of Skin and STD, Vinayaka Mission’s Kirupananda Variyar Medical College and Hospital, Vinayaka Mission’s Research Foundation (Deemed to be University), Salem, Tamil Nadu, India.
2. Postgraduate Student, Department of Skin and STD, Vinayaka Mission’s Kirupananda Variyar Medical College and Hospital, Vinayaka Mission’s Research Foundation (Deemed to be University), Salem, Tamil Nadu, India.
3. Postgraduate Student, Department of Skin and STD, Vinayaka Mission’s Kirupananda Variyar Medical College and Hospital, Vinayaka Mission’s Research Foundation
(Deemed to be University), Salem, Tamil Nadu, India.
4. Professor, Department of Skin and STD, Vinayaka Mission’s Kirupananda Variyar Medical College and Hospital, Vinayaka Mission’s Research Foundation (Deemed to be University), Salem, Tamil Nadu, India.
5. Chief and Director, Department of Skin and STD, VHS-Infectious Diseases Medical Centre Director/Site Leader-Ch
Correspondence
Seethalakshmi Gangavellaisamy,
No. 11, Mullai Nagar, Seelan Aickenpatty, Salem-636005, Tamil Nadu, India.
E-mail: dr.seethalakshmiyadav@gmail.com
Introduction: Cutaneous Adverse Drug Reactions (cADRs) are one of the most common clinical presentations in patients with Acquired Immunodeficiency Syndrome (AIDS). These patients are more prone to developing cADRs due to various factors such as altered drug metabolism, immune dysregulation, genetic predisposition, polypharmacy, and oxidative stress. Therefore, a methodical study of cADRs, including risk factors, patterns of drug eruption, and prognostic factors, is of crucial clinical significance.
Aim: To determine the prevalence of cutaneous drug reactions in Human Immunodeficiency Virus (HIV) patients and also study the various patterns of cADRs.
Materials and Methods: This cross-sectional study was conducted at the outpatient department of Infectious Diseases and Medical Centre, Voluntary Health Services, Chennai, Tamil Nadu, India, from April 2020 to December 2020. A total of 150 HIV patients above 18 years who were taking Anti Retroviral Therapy (ART) were included in this study. After screening for cADRs, it was classified as Morbilliform Eruption, Erythema Multiforme, Stevens-Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN), and Fixed Drug Eruption (FDE), etc. The severity of the reaction was graded based on the Modified Hartwig and Siegel severity assessment scale. Pearson Chi square test and Bivariate Pearson Correlation were performed to statistically analyse the data.
Results: Among the total of 150 HIV patients (87 males and 63 females), the mean age of the study population was 41.07 years. There was a male predominance with a male-to-female ratio of 1.3:1. About 44% (n=6) of the study population had opportunistic infections. The prevalence of drug eruptions in this study was found to be 6% (n=9). Out of which, 55.6% (n=5) of the population had a morbilliform eruption, and 22.7% had urticarial (n=2) and pruritus (n=2), respectively. About 56% (n=5) of the drug reactions were caused by the Tenofovir/Lamivudine/Efavirenz regimen, and the remaining 44% (n=4) of the drug eruptions were caused by the Abacavir/Lamivudine/Dolutegravir regimen.
Conclusion: The prevalence of drug eruptions in this study was 6%, and the majority of the population had a morbilliform eruption.
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