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M9480645.TXT
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1994-08-20
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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).