Abstract
A HIV-infected patient treated since eight years with all antiretroviral classes save boosted protease inhibitors, at the time of changing therapy due to an emerging genotyping resistance to non-nucleoside reverse transcriptase inhibitors, experienced repeated episodes of hypersensitivity reactions to all available boosted protease inhibitors. After documenting a combined ritonavir and lopinavir hypersensitivity by means of a specific in vitro cellular antigen stimulation test (CAST), antiretroviral therapy was safely continued with unboosted atazanavir. According to our knowledge, we report the first case of application of the in vitro CAST assay to antiretroviral intolerance, and the subsequent, specific regimen selection in a HIV-infected subject who showed multiple allergy to all boosted protease inhibitors. Further, controlled investigation is strongly needed to implement in vitro allergometric testing in patients with HIV infection and related diseases, who are prone to show unpredictable drug intolerance reactions. In fact, HIV-infected patients may suffer from frequent allergic drug reactions which may be difficult to be systematically recognized (due to the frequent, multiple concurrent pharmacotherapy), while eventual drug rechallenges are expected to be potentially dangerous.
Keywords: Ritonavir, lopinavir, hypersensitivity, clinical issues, laboratory issues, cellular allergen stimulation test (CAST)
Current HIV Research
Title: Clinical Ritonavir and Lopinavir Hypersensitivity Confirmed by a Specific In Vitro Cellular Allergen Stimulation Test
Volume: 5 Issue: 4
Author(s): Roberto Manfredi, Sergio Sabbatani and Sergio Bergonzi
Affiliation:
Keywords: Ritonavir, lopinavir, hypersensitivity, clinical issues, laboratory issues, cellular allergen stimulation test (CAST)
Abstract: A HIV-infected patient treated since eight years with all antiretroviral classes save boosted protease inhibitors, at the time of changing therapy due to an emerging genotyping resistance to non-nucleoside reverse transcriptase inhibitors, experienced repeated episodes of hypersensitivity reactions to all available boosted protease inhibitors. After documenting a combined ritonavir and lopinavir hypersensitivity by means of a specific in vitro cellular antigen stimulation test (CAST), antiretroviral therapy was safely continued with unboosted atazanavir. According to our knowledge, we report the first case of application of the in vitro CAST assay to antiretroviral intolerance, and the subsequent, specific regimen selection in a HIV-infected subject who showed multiple allergy to all boosted protease inhibitors. Further, controlled investigation is strongly needed to implement in vitro allergometric testing in patients with HIV infection and related diseases, who are prone to show unpredictable drug intolerance reactions. In fact, HIV-infected patients may suffer from frequent allergic drug reactions which may be difficult to be systematically recognized (due to the frequent, multiple concurrent pharmacotherapy), while eventual drug rechallenges are expected to be potentially dangerous.
Export Options
About this article
Cite this article as:
Roberto Manfredi , Sergio Sabbatani and Sergio Bergonzi , Clinical Ritonavir and Lopinavir Hypersensitivity Confirmed by a Specific In Vitro Cellular Allergen Stimulation Test, Current HIV Research 2007; 5 (4) . https://dx.doi.org/10.2174/157016207781023956
DOI https://dx.doi.org/10.2174/157016207781023956 |
Print ISSN 1570-162X |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4251 |
Call for Papers in Thematic Issues
Management of HIV: Management of HIV: old challenges and new needs
The aim of this thematic issue is to provide the most recent updates regarding the effective management of HIV infection. Antiretroviral therapy (ART) has significantly decreased HIV-related mortality, leading to an enhancement in the quality of life and life expectancy for people living with HIV (PLWH). Despite the numerous advancements ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Anti-inflammatory and Antioxidant Effects of <i>Lotus corniculatus</i> on Paracetamol-induced Hepatitis in Rats
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry Nanocarriers for Effective Topical Delivery of Anti-Infectives
Current Nanoscience Comparative Approach of the de novo Fatty Acid Synthesis (Lipogenesis) between Ruminant and Non Ruminant Mammalian Species: From Biochemical Level to the Main Regulatory Lipogenic Genes
Current Genomics Patterns of NSAIDs Use in Palestinian Mid-Territories: A Prospective Study of Ambulatory Patients in Outpatient Pharmacies
Current Clinical Pharmacology Mathematical and Computational Techniques for Drug Discovery: Promises and Developments
Current Topics in Medicinal Chemistry Potential Roles of HDAC Inhibitors in Mitigating Ischemia-induced Brain Damage and Facilitating Endogenous Regeneration and Recovery
Current Pharmaceutical Design Therapeutic Strategies to Reverse Local Bone Loss in Erosive Arthritis
Current Rheumatology Reviews US Guided Treat-to-Target Approach in Early RA: Implications for Uncoupling of Disease Activity and Structural Joint Damage
Current Rheumatology Reviews Pistachio Green Hull Extract Induces Apoptosis through Multiple Signaling Pathways by Causing Oxidative Stress on Colon Cancer Cells
Anti-Cancer Agents in Medicinal Chemistry The Interaction between Arachidonic Acid Metabolism and Homocysteine
Endocrine, Metabolic & Immune Disorders - Drug Targets <i>Prunella vulgaris</i> L: Critical Pharmacological, Expository Traditional Uses and Extensive Phytochemistry: A Review
Current Drug Discovery Technologies Topical Lipid Based Drug Delivery Systems for Skin Diseases: A Review
Current Drug Therapy Presentation of Lipid Antigens by CD1 Glycoproteins
Current Pharmaceutical Design COVID-19 and Thrombosis: Clinical Aspects
Current Drug Targets Gastrointestinal Stromal Tumors: A Paradigm for Therapeutic Options in Solid Organ Tumors
Mini-Reviews in Medicinal Chemistry Structure-Based Design in the GPCR Target Space
Current Medicinal Chemistry Editorial [Hot topic: Low Grade Inflammation as a Common Pathogenetic Denominator in Age-Related Diseases: Novel Drug Targets for Anti-Ageing Strategies and Successful Ageing Achievement. Part II (Executive Editors: Calogero Caruso, Thea Magrone and Emilio Jirilllo)]
Current Pharmaceutical Design Application of Liposomes in Cancer Therapy: An Assessment of the Advancement of Technology Through Patent Documents
Recent Patents on Nanotechnology Telomere Shortening Is a Sole Mechanism of Aging in Mammals
Current Aging Science Can Statin be a Novel Pharmacophore for Antidiabetic Activity?
Mini-Reviews in Medicinal Chemistry