Amprenavir-induced maculopapular exanthem followed by desensitization in a patient with late-stage human immunodeficiency virus.

Abstract

BACKGROUND:

Amprenavir, a human immunodeficiency virus type 1 (HIV-1) protease inhibitor, is approved for the treatment of HIV infection in combination with other antiretroviral agents in treatment-naive and experienced patients. Amprenavir is generally well tolerated. However, cutaneous hypersensitivity reactions to amprenavir occur in up to 28% of patients, with treatment discontinuation required in 3% of cases.

OBJECTIVE:

To report successful desensitization to amprenavir after the occurrence of a maculopapular exanthem in an HIV-infected patient with late-stage disease and limited antiretroviral treatment options.

METHODS:

Incremental doses of 0.025, 0.1, 0.25, 1, 2.5, 7.5, 25, 50, 100, 300, 600, and 1,200 mg of amprenavir oral solution were administered via percutaneous endoscopic gastrostomy tube at 20- to 30-minute intervals.

RESULTS:

The patient successfully tolerated amprenavir desensitization and has continued therapy without recurrence of rash at 19 months of follow-up.

CONCLUSION:

Desensitization may permit the continued use of amprenavir in HIV-positive patients with a history of amprenavir-induced maculopapular eruptions who have limited alternate treatment options.

• Authors: Anita Kohli-Pamnani, Phu Huynh, Francis Lobo
• Journal: Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology (Ann Allergy Asthma Immunol) Vol. 96 Issue 4 Pg. 620-3 (Apr 2006) ISSN: 1081-1206 [Print] United States
• PMID: 16680935 (Publication Type: Case Reports, Journal Article)

Chemical References

• Carbamates
• Furans
• HIV Protease Inhibitors
• Sulfonamides
• amprenavir

Topics

• Adult
• Carbamates (administration & dosage, adverse effects)
• Desensitization, Immunologic
• Drug Hypersensitivity (etiology, immunology)
• Exanthema (etiology, immunology)
• Female
• Furans
• HIV Infections (drug therapy, immunology)
• HIV Protease Inhibitors (administration & dosage, adverse effects)
• Humans
• Sulfonamides (administration & dosage, adverse effects)