AIDS. 2026 Feb 9. doi: 10.1097/QAD.0000000000004457. Online ahead of print.
ABSTRACT
BACKGROUND: People with HIV (PWH) are more susceptible to drug reactions than the general population. This study aimed to investigate the prevalence of, and demographic characteristics associated with a history of penicillin and sulfonamide allergy and Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), and to assess whether HLA-B∗57:01 is associated with these drug reactions among PWH followed in a large French multicenter cohort.
METHODS: All PWH followed from January 2000 to December 2023 with available results for HLA-B∗57:01 were included. Logistic regression models were used to identify associations between each drug allergy (outcome variable) and explanatory variables.
RESULTS: Among 35,924 PWH, the prevalence of penicillin and sulfonamide allergy and SJS/TEN were 1.05% (95%CI 0.94-1.16), 1.01% (95%CI 0.91-1.11) and 0.15% (95%CI 0.11-0.19), respectively. AIDS status was significantly associated with a higher risk of penicillin and sulfonamide allergy and SJS/TEN; while female sex was associated with sulfonamide allergy and SJS/TEN. Being born in mainland France, other European countries, and North Africa was associated with a higher risk of penicillin allergy (OR 1.88 [95%CI, 1.13-3.42], p = 0.02), while being born in Sub-Saharan Africa was associated with a lower risk of penicillin allergy (OR 0.39 [95% CI, 0.19-0.81], p = 0.009) and sulfonamide allergy (OR 0.57 [95%CI, 0.34-0.95], p = 0.03). The association between HLA-B∗57:01 and penicillin allergy was positive but statistically non-significant (OR 1.34 [95%CI, 0.87-1.97], p = 0.16).
CONCLUSION: In the combined antiretroviral therapy era, the prevalence of both penicillin and sulfonamide allergy is low. Our study confirms ethnic differences in penicillin and sulfonamide allergy.
PMID:41666357 | DOI:10.1097/QAD.0000000000004457
