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Abacavir


Presentation

  • HLA-B*5701, HLA-DR7, and HLA-DQ3 were present in combination in 13 (72%) hypersensitive patients and none of the tolerant patients (822 [43-15 675], p(c) 0.0001).[ncbi.nlm.nih.gov]
  • ” skin antigens now presented by HLA-B*57:01 molecules.[immunopaedia.org.za]
Cushingoid
  • Redistribution of body fat, including central obesity ; fat enlargement on the back of the neck and upper back (sometimes called a "buffalo hump"); wasting of the arms, legs, and face; breast enlargement; and a “cushingoid appearance” have been observed[wikilectures.eu]
  • Abstract Fat redistribution Redistribution of body fat, including central obesity ; fat enlargement on the back of the neck and upper back (sometimes called a "buffalo hump"); wasting of the arms, legs, and face; breast enlargement; and a “cushingoid[ourmed.org]
  • […] reported : Mild elevations of blood glucose, hypoglycemia, loss of appetite Postmarketing reports : Redistribution/accumulation of body fat (including central obesity, dorsocervical fat enlargement, peripheral wasting, facial wasting, breast enlargement, "cushingoid[drugs.com]
  • […] contraindications associated with all 3 drugs. 229 Adipogenic Effects Possible redistribution or accumulation of body fat, including central obesity, dorsocervical fat enlargement (“buffalo hump”), peripheral wasting, breast enlargement, and general cushingoid[web.archive.org]
Intravenous Administration
  • Coadministration with food has no significant effect on abacavir exposure; therefore, abacavir may be administered with or without food.The apparent volume of distribution of abacavir after intravenous administration is approximately 0.86 /- 0.15 L/kg[ncbi.nlm.nih.gov]
  • After intravenous administration, total clearance was 0.80 0.24 L per hour per kg (mean SD). Metabolism: In humans, abacavir is not significantly metabolized by cytochrome P450 enzymes.[dailymed.nlm.nih.gov]
  • The apparent volume of distribution of abacavir after intravenous administration is approximately 0.86 0.15 L/kg, suggesting that abacavir is distributed to extravascular spaces.[doi.org]
  • After intravenous administration, total clearance was 0.80 0.24 L/hr/kg (mean SD). Effects of Food on Oral Absorption: Bioavailability of abacavir tablets was assessed in the fasting and fed states.[web.archive.org]
Rigor
  • Ongoing rigorous pediatric drug resistance surveillance is needed.[ncbi.nlm.nih.gov]
  • In a more rigorous approach considering losses to follow-up and interruptions or switches of therapy as failures, however, the frequency of treatment failure was 22.92%.[doi.org]
Alcohol Breath
  • On arrival at the study center on the evening prior to each dosing day, subjects were given an alcohol breath test and a urine screen for illicit drug use.[doi.org]
Colic
  • Three participants had serious, treatment-related adverse events: one each with renal colic and neutropenia in the tenofovir alafenamide plus emtricitabine group, and one myocardial infarction in the abacavir plus lamivudine group.[ncbi.nlm.nih.gov]
  • Indinavir is classically associated with a wide range of urologic and renal abnormalities, including dysuria, flank pain, renal colic, hematuria, crystalluria, nephrolithiasis, acute renal failure, chronic renal failure, and papillary necrosis. [ 144[hivwebstudy.org]
Osteopenia
  • METHODS: We recently published a hip BMD improvement at week 48 [ 2.1% (95% CI: -0.6, 4.7) (P   0.043)] in HIV-infected patients with osteopenia/osteoporosis randomized to switch from tenofovir to abacavir (n   26), although without reaching statistical[ncbi.nlm.nih.gov]
Formication
  • Liquid chromatography was performed on a C18 reverse phase column (1.5 50 mm, 5 μm) isocratically at a flow rate of 0.2 mL/min using 5mM formic acid-3% (v/v) acetonitrile as the mobile phase for ABC and TFV and 5mM formic acid-35% (v/v) acetonitrile as[ncbi.nlm.nih.gov]
Paresthesia
  • Other signs/symptoms of hypersensitivity have included mouth ulceration, sore throat, adult respiratory distress syndrome, respiratory failure, edema, lymphadenopathy, hypotension, conjunctivitis, anaphylaxis, paresthesia, lymphopenia, hepatitis, liver[drugs.com]
  • ., pharyngitis, dyspnea, cough). 1 47 228 229 Lethargy, myalgia, chills, myolysis, headache, arthralgia, edema, tachycardia, abnormal chest radiographs (predominantly infiltrates, which may be localized), paresthesia, lymphadenopathy, and mucous membrane[web.archive.org]
  • Early / 10.0-10.0 fever / Early / 6.0-9.0 chills / Rapid / 6.0-9.0 rash / Early / 5.0-7.0 abdominal pain / Early / 6.0-6.0 dizziness / Early / 6.0-6.0 musculoskeletal pain / Early / 5.0-6.0 anxiety / Delayed / 5.0-5.0 infection / Delayed / 4.0-5.0 paresthesias[pdr.net]

Workup

  • Proteinuria : Although proteinuria is not specific for proximal tubular dysfunction it should also be included in the workup.[hivwebstudy.org]

Treatment

  • This study evaluated virologic outcomes in treatment-experienced patients taking ABC/3TC DRV/r compared to treatment-experienced patients taking ABC/3TC with any other PI.[ncbi.nlm.nih.gov]
  • Infection 1 4 Completed Treatment Human Immunodeficiency Virus Type 1 (HIV-1) 1 4 Completed Treatment Infection, Human Immunodeficiency Virus I 1 4 Recruiting Treatment Antiretroviral Therapy Intolerance / Patients Compliance 1 4 Recruiting Treatment[drugbank.ca]
  • The Wilcoxon signed-rank test was used to compare urinary excretion data from the abacavir treatment (treatment 1) with urinary excretion data from the abacavir-ethanol treatment (treatment 3).[doi.org]

Prognosis

  • View Article : Google Scholar : PubMed/NCBI 12 Zhang C, Chen X, Li L, Zhou Y, Wang C and Hou S: The association between telomere length and cancer prognosis: Evidence from a meta-analysis. PLoS One. 10:e01331742015.[spandidos-publications.com]

Etiology

  • Antiviral Drugs Following the identification of a human retrovirus (HIV) as the etiologic agent of the Acquired Immunodeficiency Syndrome (AIDS), an intense effort was made to identify drugs for the treatment of this debilitating, lethal disease.[web.archive.org]
  • View Article : Google Scholar : PubMed/NCBI 13 Pal J, Gold JS, Munshi NC and Shammas MA: Biology of telomeres: Importance in etiology of esophageal cancer and as therapeutic target. Transl Res. 162:364–370. 2013.[spandidos-publications.com]
  • […] presence of both HLA-B*5701 and the Hsp70-Hom M493T variant in one abacavir-tolerant individual, who also demonstrated an absent immunological response to ex vivo abacavir stimulation, suggests that there may be other necessary determinants involved in the etiology[pnas.org]
  • Potential etiologic and functional implications of genome-wide association loci for human diseases and traits. Proc Natl Acad Sci U S A 2009 ;106: 9362 - 9367 50. Jallow M, Teo YY, Small KS, et al.[doi.org]

Epidemiology

  • Author information 1 *Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland; †Analysis Group Inc, Montreal, QC, Canada; ‡Department of Epidemiology, Biostatistics and Occupational Health, McGill University[ncbi.nlm.nih.gov]
  • Epidemiological risk factors for hypersensitivity reactions to abacavir. HIV Med. 2003;4(4):321-324. doi:10.1046/j.1468-1293.2003.00166.x. 7. Martin M, Hoffman J, Freimuth R et al.[premiergx.com]
  • This topic will address the epidemiology, immunogenetics, clinical manifestations, clinical management, and screening recommendations for the abacavir hypersensitivity reaction (AHR).[uptodate.com]
  • Epidemiology: The reported frequency is 0–14% with an average of about 3.7%. The frequency is 40% higher when abacavir is used in treatment-naïve patients.[journals.lww.com]
Sex distribution
Age distribution

Pathophysiology

  • This review focuses on the current knowledge of the epidemiology, pathophysiology and clinical features of drug hypersensitivity reactions of drugs used in the management of the HIV-infected patient.[doi.org]
  • See Abacavir Hypersensitivity Testing and Initial Patient Management Algorithm in Special Instructions Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test The human leukocyte antigen[mayomedicallaboratories.com]
  • Pathophysiologic mechanism of this effect, if real, has not been identified. Other studies have not shown this risk, but they may have been under powered to show a risk of an infrequent toxicity.[hopkinsguides.com]
  • Cellular and molecular pathophysiology of cutaneous drug reactions. Am J Clin Dermatol, 3 (2002), pp. 229-238 [18] P.T. Illing, J.P. Vivian, N.L. Dudek, L. Kostenko, Z. Chen, M. Bharadwaj, et al.[elsevier.es]
  • These findings have significant implications both in terms of the clinical management of abacavir-exposed HIV-infected patients and the elucidation of basic pathophysiological mechanisms underlying this and other idiosyncratic drug hypersensitivity reactions[pnas.org]

Prevention

  • This study was designed to establish the effectiveness of prospective HLA-B*5701 screening to prevent the hypersensitivity reaction to abacavir.[ncbi.nlm.nih.gov]
  • This agent decreases HIV viral loads, retards or prevents the damage to the immune system, and reduces the risk of developing AIDS. Check for active clinical trials using this agent. ( NCI Thesaurus ) US brand name: Ziagen Code name: 1592U89[cancer.gov]
  • Ziagen prevents HIV from altering the genetic material of healthy T-cells.[hivandhepatitis.com]

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