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HIV infection is a relative contraindication for allergic immunotherapy ( AIT). In the last decade, highly active antiretroviral therapy ( HAART) has improved the immune function and life expectancy in HIV-infected patients whose respiratory allergic incidence is similar to the general population. We evaluated the safety and clinical effectiveness of sublingual immunotherapy in a group of grass pollen-allergic HAART-treated HIV-positive patients. Thirteen patients received sublingual immunotherapy ( SLIT) tablet (Oralair, Stallergenes©) and symptomatic therapy and were compared with nine patients receiving symptomatic therapy alone. Clinical benefits were evaluated by the analysis of total combined score ( TCS), sum of symptom-medication score, and a quality of life (QoL) questionnaire. HIV viral load and peripheral TCD4 lymphocytes were analyzed at the beginning and at the end of the study. Clinical efficacy data showed a significant improvement in SLIT-treated patients compared to controls ( TCS: P = 0.0001; QoL: P = 0.03). We did not observe any significant alteration of TCD4 cell counts and viral load ( VL) in both groups. Our preliminary data showed that SLIT therapy in viro-immunological controlled HAART treated HIV positive patients was efficacious, safe and well tolerated. [ABSTRACT FROM AUTHOR]

Background Injective immunotherapy is a well-known and recognized treatment for allergic diseases, but its safety has been questioned during recent years. Alternative administration routes have been proposed and there is a growing interest and experience in sublingual therapy. The safety of alternative routes is nonetheless a real advantage, so long as it is not counterbalanced by a loss of clinical benefit. Objective We have compared the efficacy of the same biologically standardized grass pollen extract administered through the injective or the sublingual route, in a group of 20 patients followed for two pollen seasons. Methods Both therapies were administered for 12 months according to a doubleblind (double-dummy) plan: at the end of the trial the cumulative dosage of the sublingual therapy was 2.4 times higher than that of the injective therapy. Data about skin reactivity, symptoms and drugs scores during the pollen season, as well as total specific IgG and specific IgG4. during and after the trial, were obtained. Results Our data show that sublingual and injective therapy are equally effective according to subjective clinical parameters, with a statistically highly significant reduction of symptoms and drugs (P = 0.002 for symptoms and drugs in SLIT-treated patients; P = 0.002 for symptoms and P = 0.0039 for drugs in patients given injections). On the other hand, objective parameters (total specific IgG, specific IgG4, skin reactivity) changed only in patients treated with active injective therapy, with P < 0.001, P < 0.001 and P = 0.021, respectively. Conclusions The discrepancies observed could be interpreted as a consequence of different mechanisms of action of the two therapies or to the lack of close relationships between the clinical and the objective parameters which were considered here. [ABSTRACT FROM AUTHOR]

Describes a case of anticonvulsant hypersensitivity syndrome induced by carbamazepine. Signs and symptoms of disease; Prevalence of serious cutaneous reactions to antiepileptic and antidepressive drugs.