Successful Desensitization Efavirenz in  8 -year-Old HIV-Positive Child

Authors

1 Associate Professor of Infectious Diseases, Tropical and Infectious Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran

2 Master Student of Immunology, Kerman University of Medical Sciences, Kerman, Iran

3 Resident of Pediatrics, Mazandaran University of Medical Sciences, Sari, Iran

4 Subspecialist in Pediatric Infectious Diseases, Tropical and Infectious Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran

Abstract

Background & Aims: Allergic reaction is a common side effect of Efavirenz and drug replacement may not be an option to physicians. Here, a successful drug desensitization experiment on an 8-year-old female child over a period of 9 days is reported. Case presentation: The patient was an 8-year old female child with HIV in Kerman, Iran who had been received oral efavirenz together with lamivudine and zidovudine. The patient had showed allergic reaction in the form of skin rashes and itchy skin right one hour after the use of the medication. Since replacing efavirenz with other medications was not an option, in this case, we developed a 9- day drug desensitization strategy in which on the first day, 300 mg of efavirenz was dissolved in 10 ml water and was given to the patient. The medication was doubled every day since after. After 9 days of drug administration, the patient was successfully desensitized toward the medication. The patient was monitored for 3 months and had no problem while using efavirenz together with lamivudine and zidovudine. Conclusion: This drug desensitization protocol for efavirenz can be recommended to physicians when medication replacement may not be an option due to the lack of drug availability.

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