However, abacavir may be continued if the only symptom is rash, with the proviso that it be discontinued immediately if other symptoms develop. If therapy is stopped due to hypersensitivity, it should not be restarted. In view of a lack of safety information on desensitization to abacavir, compounded by the risk of inducing viral resistance, such a procedure is not encouraged outside of a study setting. In discussing potential treatment strategies for patients with drug-induced hypersensitivity, Dr. Phillips remained cautious through her lecture. Conditions such as a nonpruritic skin rash in the absence of fever may not require any treatment.
Topical corticosteroids are also quite useful for symptom control.
Systemic corticosteroids will quiet down a reaction, but the reaction will often recur upon tapering the dose. Most clinicians are aware of the fact that symptoms may very well return upon stopping systemic corticosteroids therapy. Besides, the last thing many of us want to do is to keep our HIV-positive patients on chronic systemic corticosteroids therapy, so it's important to think this option through. This is also true when it comes to our patients receiving abacavir who develop progressive systemic symptoms. Again, abacavir hypersensitivity generally evolves over time, like many of the antiretroviral drugs associated with hypersensitivity reactions.