Drug reactions and desensitization in AIDS

Drug reactions are a major problem for patients with HIV infections and AIDS. The mechanisms involved in the reactions are often disputed or unknown. Immunological processes, toxic metabolites and genetic factors have been postulated to be underlying causes of these drug reactions, but full proof is lacking. A common reaction that includes cutaneous rash and fever may be associated with mucosal, hepatic and hematologic abnormalities. Reactions of this type can be produced by many different agents although the typical and best documented cause of drug reactions in HIV-infected patients is trimethoprim-sulfamethoxazole, Management of adverse drug reactions requires sound medical judgement, a knowledge of alternative treatment options, and an understanding of when to attempt and when to discontinue the drug. In some instances desensitization has proven useful.