Document 0645
 DOCN  M9480645
 TI    Acetylation phenotype and cutaneous hypersensitivity to
       trimethoprim-sulphamethoxazole in HIV-infected patients.
 DT    9410
 AU    Carr A; Gross AS; Hoskins JM; Penny R; Cooper DA; Centre for Immunology,
       St Vincent's Hospital, Sydney, Australia.
 SO    AIDS. 1994 Mar;8(3):333-7. Unique Identifier : AIDSLINE MED/94304553
 AB    OBJECTIVE: Hypersensitivity to trimethoprim-sulphamethoxazole (TMP-SMX)
       is more common in patients with HIV infection. In non-infected patients,
       TMP-SMX hypersensitivity is more common in those with a slow acetylator
       phenotype. This study was conducted to determine whether the slow
       acetylation phenotype is associated with an increased risk of
       hypersensitivity to TMP-SMX in patients with HIV infection. METHODS:
       Acetylation phenotype was determined in 28 HIV-infected subjects, of
       whom 16 had prior TMP-SMX hypersensitivity and 12 had received long-term
       TMP-SMX therapy without hypersensitivity, as well as in 29 healthy
       controls. Acetylation phenotype was determined by measuring the ratio of
       two urinary caffeine metabolites, 5-acetylamino-6-amino-3-methyl uracil
       (AAMU) and 1-methylxanthine (1-MX), after ingestion of a single 200 mg
       dose of caffeine. RESULTS: Of the 28 HIV-infected subjects, 20 (71%)
       expressed a slow acetylation phenotype and eight (29%) a fast phenotype.
       By comparison, of the 29 healthy controls, 15 (52%) expressed a slow
       phenotype (P = 0.11). Of the 16 HIV-infected subjects with prior TMP-SMX
       hypersensitivity, 15 (94%) had a slow acetylation phenotype, whereas
       only five out of 12 (42%) non-hypersensitive subjects had a slow
       acetylation phenotype (P < 0.01). CONCLUSIONS: A slow acetylation
       phenotype is a risk factor for hypersensitivity to TMP-SMX in
       HIV-infected subjects.
 DE    Acetylation  Adult  Arylamine Acetyltransferases/GENETICS/METABOLISM
       Caffeine/METABOLISM  Drug Eruptions/*ETIOLOGY  Female  Human  HIV
       Infections/*DRUG THERAPY/GENETICS/METABOLISM  Male  Middle Age
       Phenotype  Risk Factors  Support, Non-U.S. Gov't
       Trimethoprim-Sulfamethoxazole Combination/*ADVERSE EFFECTS/
       IMMUNOLOGY/METABOLISM  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).