Cutaneous Adverse Drug Reactions in Hospitalized HIV/AIDS Patients

CADR HIV AIDS antiretroviral morbiliform eruption SJS

Authors

  • Yusuf Wibisono Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
  • Indropo Agusni Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
  • Afif Nurul Hidayati
    afif_nurulhidayati@yahoo.com
    Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
  • Rahmadewi Rahmadewi Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
  • Astindari Astindari Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
  • Septiana Septiana Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
  • Maylita Sari Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia, Indonesia
  • Dwi Murtiastutik Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
July 31, 2021

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Background: Cutaneous adverse drug reaction (CADR) is the most common manifestation of drug hypersensitivity in human
immunodeficiency virus (HIV), which presented as maculopapular rash. The incidence of CADR is found to be more common
in untreated HIV patients, and the frequency is higher in severe immunodeficiency status. Early diagnosis and appropriate
treatment give better outcomes. Purpose: To evaluate the incidence and management of CADR in HIV and acquired immune
deficiency syndrome (AIDS) patients. Methods: A retrospective descriptive study of HIV/AIDS patients with CADR who
were hospitalized at Intermediate Care and Infectious Disease Centre Dr. Soetomo General Academic Hospital. Result: There
were more CADR cases in 2017, accounted 2.35% of the total Intermediate Care and Infectious Disease Centre RSUD Dr.
Soetomo General Academic Teaching Hospital ward patients. There were more male patients (62.5%), with the most
commonly found at the age of 25-44 years (64.3%), and which mostly (89.3%) originated from Surabaya. The most common
diagnosis was morbiliform eruption (60.7%), main complaint was red spots all over the body (45%), all of which are obscure
erythematous macules. The most common causes were Duviral + Neviral antiretroviral (46%) and the most common treatment
was dexamethasone injection. Conclusion: The incidence of CADR increased in 2017. The most frequent manifestation was
morbilliform eruption due to Duviral+Neviral as the first line ARV treatment. Skin management varies widely in form of
topical, oral, and intravenous injection drugs, mostly using steroid class, dexamethasone intravenous injection in particular.

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