Rash and hepatitis within days of starting a new antiretroviral regimen: nevirapine hypersensitivity, secondary syphilis or both?

Int J STD AIDS. 2014 Mar;25(3):228-30. doi: 10.1177/0956462413497703. Epub 2013 Aug 8.

Abstract

We report a case in which an HIV-positive man developed general malaise, skin rash and biochemical hepatitis within days of starting a nevirapine-based antiretroviral treatment regimen. At the same time, his syphilis serology proved positive. We discuss the diagnostic dilemma: was this a nevirapine hypersensitivity reaction, secondary syphilis or both?

Keywords: AIDS; HIV; antiretroviral toxicity; diagnosis; nevirapine; syphilis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-HIV Agents / adverse effects*
  • Anti-HIV Agents / therapeutic use
  • CD4 Lymphocyte Count
  • Diagnosis, Differential
  • Exanthema / chemically induced*
  • HIV Infections / drug therapy*
  • Hepatitis / complications
  • Hepatitis / drug therapy
  • Humans
  • Hypersensitivity / complications
  • Hypersensitivity / drug therapy
  • Kenya
  • Nevirapine / adverse effects*
  • Nevirapine / therapeutic use
  • Syphilis / diagnosis*
  • Syphilis / drug therapy
  • Treatment Outcome

Substances

  • Anti-HIV Agents
  • Nevirapine

Supplementary concepts

  • Syphilis, secondary