Cutaneous Adverse Drug Reactions in Hospitalized HIV/AIDS Patients

Y. Wibisono, I. Agusni, A. Hidayati, R. Rahmadewi, Maylita Sari, A. Astindari, Septiana Septiana, Dwi Murtiastutik
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Abstract

Background: Cutaneous adverse drug reaction (CADR) is the most common manifestation of drug hypersensitivity in humanimmunodeficiency virus (HIV), which presented as maculopapular rash. The incidence of CADR is found to be more commonin untreated HIV patients, and the frequency is higher in severe immunodeficiency status. Early diagnosis and appropriatetreatment give better outcomes. Purpose: To evaluate the incidence and management of CADR in HIV and acquired immunedeficiency syndrome (AIDS) patients. Methods: A retrospective descriptive study of HIV/AIDS patients with CADR whowere hospitalized at Intermediate Care and Infectious Disease Centre Dr. Soetomo General Academic Hospital. Result: Therewere more CADR cases in 2017, accounted 2.35% of the total Intermediate Care and Infectious Disease Centre RSUD Dr.Soetomo General Academic Teaching Hospital ward patients. There were more male patients (62.5%), with the mostcommonly found at the age of 25-44 years (64.3%), and which mostly (89.3%) originated from Surabaya. The most commondiagnosis was morbiliform eruption (60.7%), main complaint was red spots all over the body (45%), all of which are obscureerythematous macules. The most common causes were Duviral + Neviral antiretroviral (46%) and the most common treatmentwas dexamethasone injection. Conclusion: The incidence of CADR increased in 2017. The most frequent manifestation wasmorbilliform eruption due to Duviral+Neviral as the first line ARV treatment. Skin management varies widely in form oftopical, oral, and intravenous injection drugs, mostly using steroid class, dexamethasone intravenous injection in particular.
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住院HIV/AIDS患者皮肤药物不良反应
背景:皮肤药物不良反应(CADR)是人类免疫缺陷病毒(HIV)药物过敏最常见的表现,表现为黄斑丘疹。CADR的发生率在未经治疗的HIV患者中更为常见,并且在严重免疫缺陷状态中频率更高。早期诊断和适当治疗可获得更好的结果。目的:探讨HIV合并获得性免疫缺陷综合征(AIDS)患者CADR的发生率及处理方法。方法:对在苏艾托莫综合学术医院中级护理和传染病中心住院的HIV/AIDS合并CADR患者进行回顾性描述性研究。结果:2017年中级护理与传染病中心苏托莫医生综合学术教学医院病房病例数增加,占总病例数的2.35%。男性患者较多(62.5%),以25 ~ 44岁的男性患者居多(64.3%),多来自泗水地区(89.3%)。最常见的诊断是病状疹(60.7%),主要主诉为全身红点(45%),均为隐蔽性红斑。最常见的原因是杜韦病毒+奈韦病毒抗逆转录病毒(46%),最常见的治疗方法是地塞米松注射。结论:2017年CADR的发病率有所上升。最常见的表现是由于Duviral+Neviral作为一线抗逆转录病毒治疗而引起的麻疹样皮疹。皮肤治疗在局部、口服和静脉注射药物的形式上有很大的不同,主要使用类固醇类药物,特别是地塞米松静脉注射。
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