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Abstract
SHORT-TERM IMMUNO-SUPPRESSIVE THERAPY WITH PREDNISOLONE IN HIV-1-INFECTED PATIENTS RECEIVING ABACAVIR WITH OR WITHOUT NEVIRAPINE
WOOD R, WIT F, HORBAN A, BENIOWSKI M, SCHMIDT R, DE VRIES C
It has been suggested that use of prednisolone (pred) might prevent the occurrence of hypersensitivity reactions (HSR) and/or rash which are common causes of abacavir (ABC) and nevirapine (NVP) discontinuations. Objective: To determine the preventive effect of adjuvant pred use on the development of HSR/rash. Design: The CHARM trial is a randomized open-label efficacy study in naïve HIV-1 infected patients using a factorial design in which NVP and/or hydroxyurea (HU) and/or pred are added to a regimen of ABC, zidovudine and lamivudine. Pred (40 mg OD) was added the first two weeks of treatment. Analyses are based on the first 6 weeks of treatment. Methods: As it was difficult to distinguish ABC HSR from NVP rash, these events were treated as a composite endpoint. The odds ratio of developing HSR/rash for pred use was calculated with and without stratification by NVP and/or HU. Time to occurrence of HSR/rash (median days) was compared between the two study groups. Logistic regression was performed to identify risk factors for developing HSR/rash. Results: Of all patients in the study (N= 229) 114 were randomized to pred and 115 to no-pred; 19 and 11 patients resp. developed HSR/rash. The expected prevention of HSR/rash by pred use was not observed. In fact it showed an increased risk although not statistically significant (OR= 1.89, 95%CI= 0.86-4.18). Median days to development of HSR/rash in pred users and non users was 14 and 7, resp. (p=0.088). All patients received ABC. Additional risk factors for HSR/rash in the multivariate model were NVP (OR=6.36, 2.23-18.12), CD4+ cell count per 100 cells/mm3 increase (OR= 1.27, 1.06-1.52) and pred use (OR=2.34, 0.98-5.60). Conclusions: Short-term immuno-suppressive therapy with pred did not prevent HSR/rash in patients using ABC with or without NVP, however it tends to delay the occurrence. Statistically significant risk factors for the occurrence of HSR/rash are high CD4+ cell count and concomitant NVP use.
The 1st. IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
92
Suggested Citation
"WOODR, et al.
SHORT-TERM IMMUNO-SUPPRESSIVE THERAPY WITH PREDNISOLONE IN HIV-1-INFECTED PATIENTS RECEIVING ABACAVIR WITH OR WITHOUT NEVIRAPINE.
Oral Presentation:
The 1st. IAS Conference on HIV Pathogenesis and Treatment
:
Abstract no.
92"
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