A sequential approach to identify the offending medication in HIV sero-positive patients having hypersensitivity to fixed dose combination of HAART

Aim Hypersensitivity to the anti-retroviral agents is a common problem encountered in the treatment of HIV/AIDS patients. However, in resource-limited settings, where only fixed-dose combinations of the drugs are the only available option and expensive facilities of pharmacological analysis are not available, isolating the offending agent can be a challenging task. Background We, at our centre, follow a protocol to isolate such offending drug – a protocol of gradual de-challenge and re-challenge – by a method of exclusion. Materials and Methods Here, we have described a series of four cases, providing examples of usage of our own protocol to isolate the offending drug by a method of exclusion. Results and Conclusion In a resource-limited setting, where we have to use fixed-dose combination of anti-retroviral agents, management of a patient with drug hypersensitivity is a problem. Our protocol of systematic de-challenge and re-challenge, as exemplified in these cases, can be of help where expensive facilities are not available.