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Abacavir-induced febrile agranulocytosis and anaemia

机译：阿巴卡韦引起的发热性粒细胞缺乏症和贫血

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摘要

The most common side effects attributed to abacavir are gastrointestinal signs and symptoms (loss of appetite, nausea, vomiting, and diarrhoea), headache, malaise, and asthenia. These untoward events usually appear in the first few weeks of therapy, tend to resolve spontaneously, and are usually mild-to-moderate in severity.The most serious adverse event caused by abacavir is the hypersensitivity reaction, a severe allergic reaction that has been estimated to occur in around 8% of persons who begin abacavir therapy, usually within the first 6 weeks of treatment. Its multiform clinical -manifestations include fever, rash, gastrointestinal, or respiratory symptoms, and may lead to life-threatening hypotension, renal failure and death, especially in the event of rechallenge with abacavir after a prior episode of hypersensitivity. Recent studies have demonstrated that a hypersensitivity reaction to abacavir is strongly associated with the presence of the HLA-B*5701 allele, and the routine screening for this allele has significantly reduced the incidence of abacavir-associated allergic reaction in both black and white patients, with a very significant negative predictive value of 100%.
机译：阿巴卡韦最常见的副作用是胃肠道症状和体征（食欲不振，恶心，呕吐和腹泻），头痛，不适和虚弱无力。这些不良反应通常出现在治疗的最初几周内，倾向于自发缓解，严重程度通常为轻度至中度。阿巴卡韦引起的最严重的不良反应是超敏反应，据估计是一种严重的过敏反应通常在治疗的前6周内，约有8％的患者开始使用阿巴卡韦治疗。其多种形式的临床表现包括发烧，皮疹，胃肠道或呼吸道症状，并可能导致危及生命的低血压，肾衰竭和死亡，尤其是在先前过敏性发作后接受阿巴卡韦再攻击的情况下。最近的研究表明，对Acacavir的超敏反应与HLA-B * 5701等位基因的存在密切相关，并且常规筛查该等位基因已大大降低了黑人和白人患者中与Acacavir相关的过敏反应的发生率，具有非常显着的100％负面预测值。

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