abacavir and Anaphylaxis

A near-fatal hypersensitivity reaction to abacavir developed in a 62-year-old HIV-seropositive man who had been sensitized 17 months before presentation. Six days after he was rechallenged, acute respiratory distress developed, requiring mechanical ventilation for 2 weeks. Four days after extubation, he was again rechallenged. Hours later, the patient experienced anaphylactic shock, requiring mechanical ventilation for 3 weeks, aggressive volume resuscitation, and vasopressor support. Recovery was complicated by acute tubular necrosis, digital necrosis, and a GI bleed. This report reviews the mechanisms of action, efficacy, and adverse reactions of abacavir and illustrates the danger of serially rechallenging patients with this agent.

Topics: Anaphylaxis; Anti-HIV Agents; Dideoxynucleosides; Drug Hypersensitivity; HIV Infections; Humans; Male; Middle Aged; Reverse Transcriptase Inhibitors

Topics: Acquired Immunodeficiency Syndrome; Adult; Anaphylaxis; Anti-HIV Agents; Dideoxynucleosides; Drug Hypersensitivity; Humans; Male; Reverse Transcriptase Inhibitors

Topics: Anaphylaxis; Anti-HIV Agents; Dideoxynucleosides; Drug Hypersensitivity; Drug Therapy, Combination; HIV Infections; Humans; Male; Middle Aged; Reverse Transcriptase Inhibitors

Topics: Anaphylaxis; Dideoxynucleosides; Drug Hypersensitivity; Drug Therapy, Combination; Fatal Outcome; HIV Infections; HIV Protease Inhibitors; Humans; Male; Middle Aged; Nelfinavir; Reverse Transcriptase Inhibitors