Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) have become global pandemic that cause health, social, economic and political impacts. In 2010, HIV cases reached 34 million people globally. Over 95 percent of HIV infected cause death in developing countries. The reasons are social condition, poverty, and lack of health services. Even according to AIDS Epidemic Update, UNAIDS in 2009 ranked Indonesia as a country with the most rapid spread of HIV.
"So, patient of immunocompromised due to HIV infected would need antiretrovial (ARV) therapy all their life. At the start of HIV therapy with ARV, the main problem is allergies to the medicine,” said dr. Angela Satiti Retno Pudjiati, Sp.KK (K), at Faculty of Medicine UGM on Wednesday (23/11).
The lecturer in Skin and Sexual Health of the Faculty mentioned this fact when sitting in her doctoral promotion, accompanied by promoter, Prof. Dr. dr. Hardyanto Soebono, SpKK(K) and co-promoter, Prof. dr. Iwan Dwiprahasto, M.Med.Sc., Ph.D and Prof. dr. Zubairi Djoerban, SpPD-KHOM. She defended her dissertation titled Polymorphism Relations between Gene HLA and Allergies to Nevirapine in HIV/AIDS Patients in Indonesia.
Angela Satiti Retno Pudjiastuti said the allergic reaction to medicine is 100 times more often found in HIV infected patients than general population due to ARV intake. The ARV medicines that often cause allergies are nevirapine.
"The clinical manifestation of drug allergy is varied, from rash to Stevens Johnson syndrome and toxic epidermal necrolysis (TEN) that often involve extracutaneous organs such as hepar, kidney, and bone marrow that cause death, thus the drug has to stop,” said Angela Satiti.
Several genetic and non-genetic factors, according to Angela Satiti, can modify drug action so the individual response to certain drugs is varied. Difference in HLA gene in HIV infected patients is predicted to have a role in variations of therapy response or toxicity to the ARV that is given.
Polymorphism between individuals will affect vulnerability difference of a person to experience drug allergy. Thus, early detection of allergy risk factor to drug before ARV intake in HIV patient is very important to reduce morbidity and mortality due to drug allergy.
"It is thus expected that this research may help in the prevention to plan a therapy in HIV/AIDS infected case, so it can reduce morbidity and mortality due to drug allergy and improve the life of HIV/AIDS patients," she said.