Document 1135
 DOCN  M94A1135
 TI    Trimethoprime-sulfamethoxazole desensitization in HIV patients.
 DT    9412
 AU    Guerin C; Bachmeyer C; Salmon D; Barre C; Hazebroucq G; Sicard D; Sereni
       D; Pharmacie de l'Hopital Cochin, Paris, France.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(2):200 (abstract no. PB0812). Unique
       Identifier : AIDSLINE ICA10/94371440
 AB    OBJECTIVE: To evaluate efficacity of trimethoprime-sulfamethoxazole (TS)
       desensitization (DS) in HIV patients (pts). METHODS: Ten HIV-1 infected
       pts (7 men, 3 women), with a mean age of 36 years (27-50), who had to
       stop TS because of intolerance, underwent 11 episodes of DS. Patients
       were heterosexual (n = 5), homosexual (n = 2), IV drug user (n = 1),
       hemophiliac (n = 1), blood recipient (n = 1). Five pts belonged to group
       III (n = 4) and group IV (n = 6) of CDC. Intolerance occurred after a
       median time of 17 days (1-58) of treatment and consisted of fever and/or
       rash (n = 10), pruritus (n = 1). Nine patients were on prophylactic
       dosage of 160mg/800mg per day, 1 on curative dosage of PCP with
       640mg/3200mg per day. Mean CD4 cell count was 99/mm3 (1-241) at the time
       of intolerance and 82/mm3 (1-229) at the time of DS. DS protocol was as
       follows: TS suspension was given every 3 hours during 48 hours, at
       increasing doses, starting from 0.2mg/l mg to a final dose of 80mg/400
       mg. RESULTS: DS was completed in 7/11 cases with immediate success. Out
       of them, long-term success was obtained in 4 cases with a follow-up of
       173 days (54-270) and intolerance occurred within the first month in the
       3 other cases, consisting of rash and/or pruritus. Immediate failure was
       observed in 4/11 cases, with occurrence of rash and/or pruritus,
       including the pt who had adverse reaction at curative dosage. Mean CD4
       cell count did not differ between success and failure groups (82/mm3 and
       78/mm3) at the time of DS. DISCUSSION AND CONCLUSIONS: These results
       indicate that dDS in HIV pts who are intolerant to TS is not as
       efficient as reported in other studies. The difference could rely in our
       study on high immunosuppressive status or on a too rapid DS protocol. A
       prospective randomized study to evaluate efficacity of DS is required.
 DE    Adult  *Desensitization, Immunologic  Drug
       Hypersensitivity/ETIOLOGY/*THERAPY  Female  Human  HIV
       Infections/*COMPLICATIONS  *HIV-1  Male  Middle Age
       Trimethoprim-Sulfamethoxazole Combination/*ADVERSE EFFECTS  MEETING
       ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).