To the Editor: Guidelines for HIV (human immunodeficiency
virus) postexposure prophylaxis (PEP) recommend administration of zidovudine
and lamivudine with inclusion of a protease inhibitor if there is an increased
risk of HIV transmission or if resistance to zidovudine and lamivudine is
suspected.1 The guidelines do not recommend
the routine use of nonnucleoside reverse transcriptase inhibitors (NNRTIs),
but allow for their use with expert consultation. A severe hypersensitivity
reaction is a known complication of nevirapine and can present as a fulminant
hepatitis,2 or as a systemic syndrome with
predominant cutaneous manifestations referred to as hypersensitivity syndrome
(HSS) or drug rash with eosinophilia and systemic symptoms.3
We report a case of a severe systemic reaction with rash in a health care
worker shortly after administration of a nevirapine-containing PEP
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