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首页> 外文期刊>Acta Dermato-Venereologica >Severe cutaneous reactions associated with the use of human immunodeficiency virus medications.
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Severe cutaneous reactions associated with the use of human immunodeficiency virus medications.

机译：与使用人类免疫缺陷病毒药物相关的严重皮肤反应。

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Patients infected with human immunodeficiency virus are highly susceptible to adverse dermatological reactions to specific medications. Severe cutaneous conditions such as Stevens-Johnson syndrome and toxic epidermal necrolysis are associated with high morbidity and, notably for toxic epidermal necrolysis, high mortality. Although overall mortality from human immunodeficiency virus has dramatically declined owing to highly active antiretroviral therapy, these antiretroviral regimens have been associated with a wide spectrum of severe cutaneous reactions. We reviewed case reports and clinical trials in the English literature on Medline (1966 to 2001) and Aidsline (1980 to 2000) to determine the prevalence of Stevens-Johnson syndrome and toxic epidermal necrolysis attributable to the current FDA approved antiretroviral medications. We identified a total of approximately 50 patients who had Stevens-Johnson syndrome and/or toxic epidermal necrolysis associated with the use of 5 antiretroviral medications: 2 nucleoside reverse transcriptase inhibitors, zidovudine (2 patients) and didanosine (1 patient); 1 non-nucleoside reverse transcriptase inhibitor, nevirapine (42 patients); and 2 protease inhibitors, indinavir (1 patient) and amprenavir (an unspecified number within the 1% of over 1400 patients experiencing severe life-threatening reactions). Of the reports that specified the onset time of adverse reaction after initiation of treatment, 86% (19/22) of patients experienced reactions within 4 weeks. Ten of the approximately 50 patients were diagnosed with Stevens-Johnson syndrome or toxic epidermal necrolysis, due to specific antiretroviral medication, or a combination of medications identified by either resolution upon withdrawal, consistent biopsy findings or a positive rechallenge. The remainder of the identified patients were reported in articles lacking data regarding drug administration, reaction history or other details.
机译：感染人类免疫缺陷病毒的患者极易对特定药物产生不良皮肤病学反应。严重的皮肤疾病，例如史蒂文斯-约翰逊综合征和中毒性表皮坏死与高发病率相关，尤其是对于中毒性表皮坏死，死亡率高。尽管由于高度有效的抗逆转录病毒疗法，人类免疫缺陷病毒的总体死亡率已大大降低，但这些抗逆转录病毒疗法已与多种严重的皮肤反应相关。我们回顾了英文文献中有关Medline（1966年至2001年）和Aidsline（1980年至2000年）的病例报告和临床试验，以确定史蒂文斯-约翰逊综合征的发生率和可归因于当前FDA批准的抗逆转录病毒药物的毒性表皮坏死。我们确定了总共约50例患有史蒂文斯-约翰逊综合征和/或中毒性表皮坏死并与使用5种抗逆转录病毒药物相关的患者：2种核苷逆转录酶抑制剂，齐多夫定（2例患者）和去羟肌苷（1例患者）; 1种非核苷类逆转录酶抑制剂奈韦拉平（42例）;和2种蛋白酶抑制剂，indinavir（1例患者）和amprenavir（1400例经历严重危及生命的反应的患者中，有1％的人中未说明）。在指定开始治疗后出现不良反应的时间的报告中，有86％（19/22）的患者在4周内出现了反应。大约50例患者中，有10例被诊断为史蒂文斯-约翰逊综合征或中毒性表皮坏死，这是由于特定的抗逆转录病毒药物或联合撤药，活检结果一致或再攻击阳性而确定的药物组合。其余已鉴定患者的报道在文章中缺乏有关药物管理，反应史或其他细节的数据。

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