Abacavir neutropenia

Severe or fatal hypersensitivity reactions can occur within hours after reintroduction of abacavir in patients who have no identified history or unrecognized symptoms of hypersensitivity to abacavir therapy (see Warnings and Adverse Reactions). Zidovudine has been associated with hematologic toxicity, including neutropenia and severe anemia, particularly in patients with advanced HIV disease (see Warnings). Prolonged use of zidovudine has been associated with symptomatic myopathy. 

In an open, 48-week, single-arm, multicenter phase II study in 99 patients abacavir 300 mg bd, amprenavir 1200 mg bd, and efavirenz 600 mg/day were associated with rashes in 50 patients, possibly because of abacavir hjrpersensitivity 17 permanently discontinued one or more drugs as a result (5). Other adverse effects included nausea (n = 41), diarrhea (n = 27), sleep disorders (n = 27), dizziness (n = 25), fatigue (n = 23), hypertriglyceridemia (n = 18), neutropenia (n = 8), hyperamylasemia (n = 4), leukopenia (n = 3), hypercholesterolemia (n = 2), raised alkaline phosphatase (n = 1), and raised aspartate transaminase (n = 1). 

In a 24-week open, single-arm trial, 108 antiretroviral therapy-naive, HIV-infected prisoners were given a combination tablet of lamivudine -I- zidovudine (150 mg/300 mg) and a tablet of abacavir 300 mg bd (2). The plasma HIV-1 RNA concentration remained at 400 copies/ml or less in 85% of the patients and at less than 50 copies/ml in 75%. Nausea was the most common adverse effect (n = 40). Four patients withdrew prematurely because of one or more of the following abdominal discomfort and pain abdominal distension neutropenia malaise or fatigue nausea and vomiting. Two patients had a suspected hypersensitivity reaction to abacavir and were withdrawn. 

Hematologic Neutropenia (neutrophil count 80 X 10 /1) occurred in a 38-year-old woman who took abacavir - - lamivudine with lopina-vir -I- ritonavir for 3 weeks [93 ]. She had a fever and mild erythema and edema on the face, trunk, and arms. She was positive for HLA-B 5701. Subsequent therapy with teno-fovir -I- emtricitabine and lopinavir - - ritonavir was uneventful. 

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See also in sourсe #XX -- [ ]

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