Nevirapine induced stevens Johnson syndrome: A case report

Abstract

Adverse drug reactions (ADRs) are one of the major reasons for morbidity and mortality in India, but they often go undetected and under reported. Nevirapine (NVP) is one of the first line agents used for anti retroviral treatment (ART) of human immunodeficiency virus (HIV) infection. It is known to cause mild skin rash among these individuals during the first weeks of therapy, however Stevens Johnsons Syndrome (SJS) is rare. Here we report afifty three-year-old HIV positive individual presenting with maculopapular rash all over the body and ulcerations of the oral and genital mucosa following administration of NVP. He was diagnosed to have SJS. The symptoms resolved completely 2 weeks after stopping the drug. Causality assessment using Naranjo and the World Health Organisation (WHO) probability scale indicated a probable relationship between the patient’s symptoms and the use of NVP. Thus, clinicians should be vigilant to allow early detection of these problems, as the early diagnosis and treatment of SJS can reduce the morbidity and mortality considerably.