Nevirapine and/or Co-Trimoxazole Induced Stevens Johnson syndrome in HIV Infected Patient - A Case Report
Kaksha Patel, Ashwin Panchasara, Bhargav Purohit and C.B. Tripathi
Affiliation: (C.B. Tripathi) Department of Pharmacology, Government Medical College and Sir Takhtsinhji General Hospital, Bhavnagar-364001 (Gujarat), India.
A 46 years old HIV reactive patient developed Stevens Johnson syndrome (SJS) probably due to nevirapine
and/or co-trimoxazole. Patient was on zidovudine + lamivudine + nevirapine along with Co-trimoxazole since last two
months. After 15 days, zidovudine was replaced with stavudine due to development of anemia. All these drugs were
stopped after development of reaction. Temporal association was found between stavudine, lamivudine, nevirapine, cotrimoxazole
and development of the reaction. Nevirapine and Co-trimoxazole were suspected to cause this reaction most
probably due to associated hepatotoxicity and their common potential to cause SJS. In our case, patient died despite
stopping of all medications.
Keywords: Anti-retroviral therapy, Co-trimoxazole, Hepatotoxicity, HIV, Nevirapine, Stevens Johnson syndrome, Adverse
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