Immune-mediated adverse drug reactions to HIV and TB treatments in South Africa

Background information

Immunologically-mediated adverse drug reactions (IM-ADRs), which are adverse drug reactions involving an abnormal immune system response, are a significant obstacle to the successful treatment of both human immunodeficiency viruses (HIV) and tuberculosis (TB) internationally. They are a particular problem in South Africa where 1 in 4 individuals in the population is HIV-infected and 1 in 5 patients with HIV develops a cutaneous adverse drug reaction during treatment.

Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) and drug reaction with eosinophilia and systemic symptoms (DRESS) are severe IM-ADRs that have mortalities that can exceed 40% and lead to prolonged hospitalization, higher healthcare costs, and significantly constricted treatment options. 

About the study

Collaboration between CDSI, the University of Cape Town, South Africa, and Walter Sisulu University, South Africa, enabled the expansion of a data registry and biorepository that helped physician-scientists research IM-ADRs in underrepresented areas of South Africa. Dr. Elizabeth Phillips served as a Co-PI on this National Institutes of Health (NIH) funded study along with Co-PI Graeme Ayton Meintjes, MBBS, University of Cape Town.  

The role of Dr. Elizabeth Phillips and CDSI in this study was to receive samples for analysis and expert data interpretation. Samples were from pre-existing and new child and adult IM-ADR cases from the University of Cape Town (Groote Schuur Hospital) and Walter Sisulu University (Nelson Mandela, Frere and Cecilia Makiwane Hospitals). This research will empower physician-scientists to better identify those who are at risk for severe adverse drug reactions before prescribing drugs, aid in diagnosis, and develop new treatments for IM-ADRs. 

Questions? 

Please email drugsafetyresearch@vumc.org for more information.