Adverse drug reactions in HIV seropositive patients

Patients infected with the human immunodeficiency virus (HIV) will receive a number of drugs intended to fight the HIV infection itself or to avoid and treat its complications. In these patients, adverse drug reactions (ADRs) are unusual in their frequency, not in their type. They may involve all the systems and reduce the already limited therapeutic possibilities. The frequent absence of therapeutic alternatives may require, for certain reactions, the continuation of the suspected drug. The study of these patients may provide better comprehension of the mechanisms responsible for ADRs occurring in immuno‐competent patients, since the association of certain diseases with certain drugs increases the risk of drug reactions. The search for an enhancing, synergistic or at least a non‐neutralizing mechanism may improve the study or the prevention of all ADRs. The spread of HIV infection and the attempt to maintain the infected patient at home means that any physician is likely to be confronted with the diagnosis and treatment of a drug‐related toxicity in an HIV‐positive patient. In May 1993, a certain number of physicians who had specialized in the treatment of HIV‐infection and/or in management of ADRs, met to discuss the different toxicities observed with the drugs most often employed in this illness. The description, the incidences and the recommendations which are presented in this report reflect the opinion of a large majority — and often the unanimity — of the participants.