Abacavir Hypersensitivity Reaction: an Update

Hughes, Christine; Foisy, Michelle; Dewhurst, Norman; Higgins, Noelle; Robinson, Linda; Kelly, Deborah; Lechelt, Kelly E

doi:10.1345/aph.1k522

Cited by 66 publications

(50 citation statements)

References 45 publications

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“…Recently, candidate gene studies and genomewide analyses have identified several genetic markers associated with increased hepatotoxicity risk. Thus, flucoxacillin-induced hepatotoxicity is closely linked to HLAB5701 (15), the same allele responsible for susceptibility reactions to abacavir, which is present in at least 4% of Caucasian Europeans (16). Estrogen-induced cholestasis is associated with mutations in gene ABC B11, which codes for the bile salt export pump (17), and valproate-related liver toxicity is linked to mutations in the gene encoding mitochondrial DNA polymerase gamma, POL G1 (18).…”

Section: Risk Factorsmentioning

confidence: 99%

Hepatotoxicity in 2011: advancing resolutely

Lozano-Lanagrán

Robles

Lucena

et al. 2011

Rev. esp. enferm. dig.

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Section: Risk Factorsmentioning

confidence: 99%

Hepatotoxicity in 2011: advancing resolutely

Lozano-Lanagrán

Robles

Lucena

et al. 2011

Rev. esp. enferm. dig.

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“…Abacavir hypersensitivity syndrome is characterized by gastrointestinal symptoms including nausea, vomiting, abdominal cramping, respiratory symptoms including coughing and shortness of breath and constitutional symptoms including fever, body rash and weight loss 3 . Some studies have also linked abacavir to an increased risk of myocardial infarction 4 .…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Abacavir Hypersensitivity Syndrome

Bennin¹

2010

TMF

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A 56-year-old African American male with a history of type II diabetes mellitus complicated by neuropathy, infections with human immunodeficiency virus (HIV), with a known CD4 count of 25 per cubic millimeter, hepatitis B and hepatitis C presented with six months of generalized weakness over his lower extremities, poor balance, nausea and vomiting. The patient had recently started anti-retroviral therapy (ART) and noticed that the onset of his symptoms coincided with the initiation of this therapy. He was taking Trizivir, which consists of abacavir (300mg each day), lamivudine (150mg each day), and zidovudine (300mg each day), atazanavir (300mg each day) and ritonavir (100mg each day). The patient was also taking trimethoprim/sulfamethoxazole (TMP-STX) and fluconazole as prophylaxis against opportunistic infections. He described his generalized weakness as musculoskeletal and involving all his extremities, especially his legs: it was exacerbated with activity and relieved with rest. This weakness had led to gait instability without falls. He noted that his nausea was constant and had resulted in non-bilious, non-bloody emesis. He vomited approximately 2-3 times per day for 3 days. As a result, he had poor oral intake. He denied any fevers but he did report chills. He also reported a 40-lb weight loss over 3 months. Of note, he noticed that his symptoms diminished when he stopped taking of his ART medications. As a result, the patient had been non-compliant with his ART. He denied any significant alcohol consumption or recreational drugs use.

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“…Abacavir is a nucleoside reverse transcriptase inhibitor that has been prescribed to almost 1 million HIV patients during the past decade and which is used in combination with other medications to treat HIV infection (37). In white populations, hypersensitivity reaction (HSR) occurs within the first 6 weeks of therapy in 5%-8% of patients receiving this drug.…”

Section: Hypersensitivity Reactions and Variations Of Major Histocompmentioning

confidence: 99%

Toward theragnostics

Pène¹,

Courtine²,

Cariou³

et al. 2009

Critical Care Medicine

196

105

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Theragnostics is a treatment strategy that combines therapeutics with diagnostics. It associates both a diagnostic test that identifies patients most likely to be helped or harmed by a new medication, and targeted drug therapy based on the test results. Bioinformatics, genomics, proteomics, and functional genomics are molecular biology tools essential for the progress of molecular theragnostics. These tools generate the genetic and protein information required for the development of diagnostic assays. Theragnostics includes a wide range of subjects, including personalized medicine, pharmacogenomics, and molecular imaging to develop efficient new targeted therapies with adequate benefit/risk to patients and a better molecular understanding of how to optimize drug selection. Furthermore, theragnostics aims to monitor the response to the treatment, to increase drug efficacy and safety. In addition, theragnostics could eliminate the unnecessary treatment of patients for whom therapy is not appropriate, resulting in significant drug cost savings for the healthcare system. However, the introduction of theragnostic tests into routine health care requires both a demonstration of cost-effectiveness and the availability of appropriate accessible testing systems. This review reports validation studies in oncology and infectious diseases that have demonstrated the benefits of such approach in well-defined subpopulations of patients, moving the field from the drug development process toward clinical practice and routine application. Theragnostics may change the usual business model of pharmaceutical companies from the classic blockbuster model toward targeted therapies.

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Abacavir Hypersensitivity Reaction: an Update

Cited by 66 publications

References 45 publications

Hepatotoxicity in 2011: advancing resolutely

Hepatotoxicity in 2011: advancing resolutely

A Rare Case of Abacavir Hypersensitivity Syndrome

Toward theragnostics

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