Skin infiltrating T-cell profile of drug reaction with eosinophilia and systemic symptoms (DRESS) reactions among HIV-infected patients

• Published in: Frontiers in medicine 2023-05, Vol.10, p.1118527-1118527
• Main Authors: Chimbetete, Tafadzwa, Choshi, Phuti, Pedretti, Sarah, Porter, Mireille, Roberts, Riyaadh, Lehloenya, Rannakoe, Peter, Jonathan
• Format: Article
• Language: English
• Subjects: drug reaction with eosinophilia and systemic symptoms; first-line tuberculosis drug; human immunodeficiency virus; immunohistochemistry; Medicine; severe cutaneous adverse reaction; T-cell
• ISSN: 2296-858X; 2296-858X
• DOI: 10.3389/fmed.2023.1118527

Drug Reaction with Eosinophilia Systemic Symptoms (DRESS) is more common in persons living with HIV (PLHIV), and first-line anti-TB drugs (FLTDs) and cotrimoxazole are the commonest offending drugs. Limited data is available on the skin infiltrating T-cell profile among DRESS patients with systemic CD4 T-cell depletion associated with HIV. HIV cases with validated DRESS phenotypes (possible, probable, or definite) and confirmed reactions to either one or multiple FLTDs and/or cotrimoxazole were chosen (  = 14). These cases were matched against controls of HIV-negative patients who developed DRESS (  = 5). Immunohistochemistry assays were carried out with the following antibodies: CD3, CD4, CD8, CD45RO and FoxP3. Positive cells were normalized to the number of CD3+ cells present. Skin infiltrating T-cells were mainly found in the dermis. Dermal and epidermal CD4+ T-cells (and CD4+/CD8+ ratios) were lower in HIV-positive vs. negative DRESS;