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Arzneimittelexantheme bei Therapie der HIV-Infektion mit Efavirenz und Nevirapin

Rashes in HIV-infected patients undergoing therapy with nevirapine or efavirenz

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Zusammenfassung

Efavirenz und Nevirapin zählen zu den oft verwendeten Medikamenten bei HIV-Infektion. Wichtige Nebenwirkung dieser Substanzen sind Arzneimittelexantheme. In der vorliegenden Studie werden die Exantheme als häufigste Nebenwirkung beider Substanzen charakterisiert.

In einer prospektiven nichtrandomisierten Multicenterstudie wurden 662 HIV-infizierte Patienten mit einer antiretroviralen Kombinationstherapie mit Efavirenz (n=325) oder Nevirapin (n=337) eingeschlossen. In dieser Studie wurden Häufigkeit und Dauer der Exantheme sowie Rezidivexantheme bei Reexposition erfasst.

Insgesamt traten bei 4,5% (n=30) der Patienten Exantheme auf (Nevirapin: 2,4%, Efavirenz: 6,4%). Bei 4 Patienten wurde die Therapie bei einem aufgetretenen Exanthem nach einer Einzelfallentscheidung fortgeführt; bei 3 Personen wurden die initial verwendeten Medikamente bei Reexposition toleriert.

Bei Arzneimittelexanthemen unter Nevirapin- oder Efavirenztherapie kann bei fehlender Blasenbildung, Schleimhautbeteiligung oder systemischen Zeichen eine Therapiefortsetzung erwogen werden.

Abstract

Efavirenz and nevirapine are frequently used drugs in antiretroviral therapy. Rashes are common side effects of these drugs. In this study, we examined the characteristics of efavirenz- and nevirapine-associated rashes.

This prospective nonrandomized multicenter study included 662 HIV-infected patients (efavirenz: 325, nevirapine: 337) to determine incidence, duration, cross-reactivity, and outcome upon reexposure.

Of the treated patients, 4.5% (n=30) developed rashes (nevirapine: 2.4% and efavirenz: 6.4%). In four patients treatment was not interrupted. Three patients were reexposed to the initial drug without any side effects.

Therapy with nevirapine or efavirenz does not have to be interrupted if rashes exhibit no blistering, mucosal manifestations, or systemic signs.

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Authors and Affiliations

  1. Hautklinik, Universität, Heidelberg

    M. Hartmann & D. Petzoldt

  2. Schwerpunktpraxis, Mannheim

    J. Brust & D. Schuster

  3. Schwerpunktpraxis, Karlsruhe

    F. Mosthaf & M. Procaccianti

  4. Schwerpunktpraxis, Freiburg

    J. A. Rump

  5. Medizinische Universitätsklinik, Würzburg

    H. Klinker

  6. Hautklinik, Universität, Voßstraße 2, 69115, Heidelberg

    M. Hartmann

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  1. M. Hartmann
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  2. J. Brust
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  3. D. Schuster
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  4. F. Mosthaf
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  5. M. Procaccianti
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  7. H. Klinker
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  8. D. Petzoldt
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Correspondence to M. Hartmann.

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Hartmann, M., Brust, J., Schuster, D. et al. Arzneimittelexantheme bei Therapie der HIV-Infektion mit Efavirenz und Nevirapin. Hautarzt 56, 847–853 (2005). https://doi.org/10.1007/s00105-005-0911-z

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  • DOI: https://doi.org/10.1007/s00105-005-0911-z

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