[Allopurinal-induced aseptic menigitis].
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Biomedical subjects
Publications and source records attributed to Damien Bouhour.
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INTRODUCTION: Syphilis remains a current infection in France, with an increase in cases associated with the increase in sexual practices at risk. OBSERVATION: An HIV-seropositive homosexual male presented with a perturbed hepatic profile and roseola-like exanthema 15 days after starting treatment with Trizivir. Because of the combination of hepatitis and cutaneous eruption evoking hypersensitivity to abacavir, treatment was suspended, but no improvement was noted. The diagnosis of syphilitic hepatitis associated with roseola was made following a sero-conversion and improvement was obtained with benzathine-penicillin and the re-introduction of Trizivir without further problem. COMMENTS: This case report underlines the possibility of discovering syphilis when confronted with cholestatic and cytolytic hepatitis that regresses with penicillin and is isolated or associated with evocative cutaneous signs.
BACKGROUND: Suboptimal levels of antiretroviral drugs result in virologic failure in HIV-infected patients treated with highly active antiretroviral therapy (HAART). OBJECTIVE: To assess the relationship between levels of indinavir in hair and virologic outcome. DESIGN: Cross-sectional study. SETTING: 7 AIDS clinics in France. PATIENTS: 89 HIV-infected patients who received HAART that included indinavir. MEASUREMENTS: Patients were classified as responders or nonresponders on the basis of viremia at the time of hair collection. In nonresponders, levels of indinavir in hair and resistance mutations in the protease gene were assessed at baseline and at the time of indinavir measurement. RESULTS: Mean indinavir levels (+/-SD) were significantly higher in the 65 responders than in the 24 nonresponders (24.4 +/- 16 microg/g vs. 12.9 +/- 8.6 microg/g) (P < 0.001). Nonresponders with intermediate levels of indinavir in hair had more mutations in the protease gene than did nonresponders with low levels of indinavir in hair. CONCLUSION: Indinavir levels in hair are associated with virologic outcome in patients receiving HAART.