Table 1.
Drugs associated with hypersensitivity reactions in HIV
| A. | Drug class | Drug(s) in class | Commonest offending drugs for IM-ADRs | Types of reactions and estimated incidence |
|---|---|---|---|---|
| Antiretrovirals | NRTI | Tenofovir | Abacavir | Abacavir hypersensitivity reactions (2.3–9% – population dependent) [80–83] |
| Abacavir | ||||
| Emtricitabine | ||||
| Lamivudine | ||||
| Didanosine | ||||
| Stavudine | ||||
| Zidovudine | ||||
| Tenofovir | CADR – including MPE, photoallergic dermatitis, LDE 5–7% [84–86,20] | |||
| NNRTI | Nevirapine | Nevirapine | CADR: 15–32% | |
| Efavirenz | DRESS: 5% | |||
| Rilpivirine | SJS/TEN: 0.3–10% [8,9,20,87] | |||
| Etravirine | ||||
| Efavirenz | CADR 6% [9,66] | |||
| SCAR 0.1% [88] | ||||
| PI | Lopinavir | Fosamprenavir | CADR, SCAR 3–8% [84,89] | |
| Atazanavir | ||||
| Ritonavir | ||||
| Saquinavir | ||||
| Darunavir | ||||
| Fosamprenavir | ||||
| Tipranavir | ||||
| Indinavir | ||||
| Integrase strand transfer inhibitors | Dolutegravir | Dolutegravir | DHS, DILI 1% [17] | |
| Raltegravir | ||||
| Elvitegravir | ||||
| Bictegravir | ||||
| Fusion or CCR5 inhibitor | Maraviroc Enfuvirtide | Enfuvirtide | CADR <1% [89] | |
| Fixed dose combinations | Tenofovir+emtricitabine | Tenofovir+emtricitabine | DHS, rare, case report [90] | |
| Tenofovir+emtricitabine +efavirenz | ||||
| Tenofovir+lamivudine+efavirenz | ||||
| Tenofovir+emtricitabine+cobicistat+elvitegravir | ||||
| Tenofovir +emtricitabine + efavirenz | CADR, unknown, case reports [80,91] |
| B. | Antiinfectives commonly used in HIV | ||
|---|---|---|---|
| Drugs | Common drugs causing increased IM-ADRs in HIV | Type of reactions and estimated incidence | |
| Antibacterials | Beta-lactam antibiotics | Cotrimoxazole (TMP-SMX) | CADR – 10.9% [27] |
| Macrolides | SCAR – mainly DRESS/DHS, FDE, SJS/TEN [24–26] | ||
| Quinolones | |||
| Cotrimoxazole | |||
| (TMP/SMX) (PJP) | |||
| Dapsone | |||
| Dapsone | SCAR – mainly DRESS/DHS 1.4% [92,93] | ||
| Antifungals | Amphotericin | Fluconazole | FDE, DRESS, SJS/TEN – unknown, mainly case reports [20,94,95] |
| Azoles | |||
| Allylamines | |||
| Griseofulvin | |||
| echinocandins | |||
| Antimycobacterials | First-line | Standard anti-TB treatment | CADR, AIN – adjusted hazard ratio of 8 in HIV [74,96–99] |
| Rifampicin | |||
| Isoniazid | |||
| Pyrazinamide | |||
| Ethambutol | |||
| Second-line/DR-TB | |||
| Fluroquinolones | |||
| Kanamycin/Capreomycin/Amikacin | |||
| Bedaquiline | |||
| Ethionamide | |||
| Rifampicin | CADR, SCAR, DILI, AIN, immediate reactions [100,101] | ||
| Isoniazid | CADR, SCAR, DILI mainly case series [102,103] | ||
| Pyrazinamide | CADR 2.8%, SCAR, DILI [20,104] | ||
| Ethambutol | SCAR – SJS/TEN, DRESS [92,102,105–107] | ||
| Fixed dose combinations (Rifafour) | Mainly case reports [108] | ||
| Fluoroquinolones Ethionamide Kanamycin/Amikacin | SCAR ~20% [99] | ||
AIN, acute interstitial nephritis; CADR, cutaneous adverse drug reactions; DHS, drug hypersensitivity syndrome; DILI, drug-induced liver injury; DRESS, drug reaction with eosinophilia and systemic symptoms; FDE, fixed drug eruption; LDE, lichenoid drug eruption; MPE, maculopapular eruption; NNRTI, nonnucleoside reverse-transcriptase inhibitors; NRTI, nucleoside reverse transcriptase inhibitor; PI, protease inhibitor; SCAR, severe cutaneous adverse reactions; SJS/TEN, Stevens–Johnson syndrome and toxic epidermal necrolysis; TMP-SMX, trimethoprim sulfamethoxazole (cotrimoxazole).