The factors associated with co-trimoxazole hypersensitivity in people living with HIV/AIDS: a retrospective study

Abstract

Background: Antibiotic adverse drug reactions (ADRs) can occurred during any treatment of infection, especially opportunistic infections in people living with HIV/AIDS (PLWHA). Co-trimoxazole is a sulfonamide fixed dose combination antibiotic, consisted of sulfamethoxazole and trimethoprim which is effective in treatment of several infections and for prophylaxis of pneumocystis jiroveci pneumonia. The universal use of co-trimoxazole for prophylaxis has been shown to decrease hospitalizations, morbidity and mortality among PLWHA, but potentially associated with ADRs include drug hypersensitivity reaction. The objective was to identify factors associated with co-trimoxazole hypersensitivity in PLWHA.Methods: A retrospective study were enrolled 404 participants PLWHA who were received co-trimoxazole due to co-trimoxazole prophylaxis therapy (CPT), between January 2015–December 2018. The independence variables such as age, sex, history of allergy, hypersensitivity reactions, duration of therapy (days), CD4 (cells/µl) and opportunistic infection to co-trimoxazole hypersensitivity reaction were analyzed using spearman test.Results: Mostly of the participants was male: 253 (62.60%). Eighteen (4.50%) with history of allergy, 64 (15.90%) were known co-trimoxazole hypersensitivity reaction. The most frequent clinical manifestation was maculopapular rash: 27 (42.3%), followed by urticaria alone: 17 (26.3%), fixed drug eruption: 12 (19.6%), and angioedema with or without urticaria: 8 (11.8%). The history of allergy, opportunistic infection and duration of treatment were associated factors to co-trimoxazole hypersensitivity reaction.Conclusions: This study was identified, that history of allergy, duration of treatment and opportunistic infection were factors associated with co-trimoxazole hypersensitivity in PLWHA.