HAART: a risk factor for development of porphyria cutanea tarda?

Filho, Fred Bernardes; Quaresma, Maria Victória; Carvalho, Felipe de Matos Pinto de Nazareth; Castro, Carlos Gustavo Carneiro de; Dobao, Elisabete; Lyra, Marcelo Rosandiski; Menezes, Vinícius de; Nery, José Augusto da Costa

doi:10.1590/s0037-86822012000600022

Cited by 9 publications

(4 citation statements)

References 6 publications

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“…During follow‐up, precipitating factors have to be treated and prevented. All HIV patients in this study received HAART and responded well to therapy differently to the report by Bernardes Filho et al., which refers to the occurrence of PCT manifestations with the use of HAART. Furthermore, cessation of estrogen use may be followed by improvement of disease‐related symptoms, and all women suspended estrogens successfully.…”

Section: Discussionmentioning

confidence: 75%

Experience in management of porphyria cutanea tarda in a tertiary referral Brazilian hospital from 2002 to 2017

2019

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Background Porphyria cutanea tarda (PCT) is the most common porphyria worldwide.The known acquired precipitating factors that induce PCT include alcoholism, hepatitis C virus infection, human immunodeficiency virus infection, and estrogen intake. Hereditary hemochromatosis is considered an inherited risk factor. The aim of this study was to describe and analyze precipitating factors and family history, with emphasis on PCT management. Methods A retrospective study of 87 patients with PCT was conducted between January 2002 and December 2017.Results A male predominance of 1.8 : 1 was found. The median age at diagnosis was 49 years (range 18-71). Family history of PCT was observed in 19.5% of patients. Two or more acquired precipitating factors were present in 42.5%. Patients were treated with antimalarial monotherapy (72.4%), antimalarial combined with phlebotomy (22.9%), and only with phlebotomy (4.6%). Acquired precipitating factors and inherited factors were not associated with treatment group. There was a difference in 24 h-UP normalization rate between treatment groups; combined therapy takes longer than antimalarial monotherapy, 38 months versus 15 months, respectively (CI 95%, 6.5-63.5 vs. 12.9-17) (log-rank test, P = 0.004).Conclusion Precipitating factors did not seem to be associated with treatment choice; however, all acquired and inherited precipitating factors should be investigated, and the choice between phlebotomy and/or antimalarials should be individualized. All dermatologists treating PCT patients should observe transferrin saturation and ferritin levels to search for underlying hereditary hemochromatosis. * P = 0.021 according to a t-test.

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Section: Discussionmentioning

confidence: 75%

Experience in management of porphyria cutanea tarda in a tertiary referral Brazilian hospital from 2002 to 2017

2019

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“…With that, porphyrins - uroporphyrin and 7-carboxyl-porphyrinogen - are cumulative, and may be excreted in the urine and feces or deposited in various tissues throughout the body. 1-4 …”

Section: Discussionmentioning

confidence: 99%

Porphyria cutanea tarda in a HIV- positive patient

Franzon

Mikilita

Camelo

et al. 2016

An. Bras. Dermatol.

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This is a case report about Porphyria cutanea tarda (PCT) and its relationship with the infection caused by the human immunodeficiency virus (HIV). Cutaneous porphyria is an illness caused by enzymatic modification that results in partial deficiency of uroporphyrinogen decarboxylase (Urod), which may be hereditary or acquired. Several studies suggest that HIV infection associated with cofactors might trigger the development of porphyria cutanea tarda. In this case report, we present a patient infected with HIV, who after the introduction of antiretroviral therapy (ART) enjoyed clinical improvement of porphyria cutanea tarda symptoms.

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“…The literature review showed six cases of PCT associated with highly active ART (HAART). [ 10 ] However, the interval from the first administration of HAART treatment to the onset of PCT ranged from 3 days to 4 months. Since our patient developed features of PCT after almost 3 years of HAART, it is unlikely that PCT in him was precipitated by HAART.…”

Section: Discussionmentioning

confidence: 99%