alexa A Comparative Insight into the Incidence of Steven Johnson Syndrome/ Toxic Epidermal Necrolyis among the Immunocompromized Patient Populace of Eastern India with a Distinctive Emphasis on the Possible Association of Human Cytomegalovirus
ISSN 2155-6113

Journal of AIDS & Clinical Research
Open Access

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Research Article

A Comparative Insight into the Incidence of Steven Johnson Syndrome/ Toxic Epidermal Necrolyis among the Immunocompromized Patient Populace of Eastern India with a Distinctive Emphasis on the Possible Association of Human Cytomegalovirus

Aroni Chatterjee1, Indranil Thakur2, Sabbir Ansari1#, Rajendra Prasad Chatterjee1#, Rathindranath Sarkar2, Shuvashish Kamal Guha3 and Nilanjan Chakraborty1*

1ICMR Virus Unit, Kolkata, India

2Calcutta Medical College and Hospital, Kolkata, India

3ART Centre, Virology Department, School of Tropical Medicine College and Hospital, Kolkata, India

4#Both the authors contributed equally

*Corresponding Author:
Nilanjan Chakraborty
PhD, ICMR Virus Unit, 57
Dr. S.C. Banerjee road, Beliaghata
Kolkata-700010, India
Tel: 91-33-9163785518
E-mail: [email protected]

Received date: June 02, 2017; Accepted date: June 24, 2017; Published date: June 29, 2017

Citation: Chatterjee A, Thakur I, Ansari S, Chatterjee RP, Sarkar R, et al. (2017) A Comparative Insight into the Incidence of Steven Johnson Syndrome/Toxic Epidermal Necrolyis among the Immunocompromized Patient Populace of Eastern India with a Distinctive Emphasis on the Possible Association of Human Cytomegalovirus. J AIDS Clin Res 8:706. doi:10.4172/2155-6113.1000706

Copyright: © 2017 Chatterjee A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Stevens-Johnson syndrome (SJS) and its more advanced form, Toxic Epidermal Necrolysis (TEN) are severe adverse cutaneous reactions that predominantly involve skin and mucous membranes. In view of the current dearth of documented knowledge, this study the first of its kind from India was designed to categorically distinguish and compare the different associated factors and clinical manifestations relevant to the development of SJS/TEN syndrome among the immunocompromised (Human Immunodeficiency Virus 1 seropositive) patients in Eastern India. 16 out of 29 patients (55.1%) were found to be suffering from drug induced SJS or TEN, while the rest (44.8%) had severe pathogenic involvements. Neviraprine use was found to be the major cause among drug involved SJS (53.8%) and TEN (66.66%) cases followed by allopurinol use. The frequency of incidence of kidney disease (67% in SJS and 54% in TEN) and neurological impairment (42% SJS and 37%TEN) was found to be significantly higher among the SJS patients whereas that of hepatitis (38% SJS and 47% TEN) , ocular dysfunction (49% SJS and 63% TEN) and pulmonary dysfunction (47% SJS and 53% TEN) were higher among the TEN patients. This study also had another prominent motive, which is to elucidate the possible role of human cytomegalovirus in triggering the exfoliative inflammatory disease conditions among these patients. The incidence rate of SGPT and SGOT were significantly higher in TEN patients than in SJS (p=0.001 and p=0.002) . Mean sodium level in blood was within normal range in both the groups whereas potassium and chloride levels were much higher than normal Out of the 29 HIV seropositive patients with SJS/TEN we studied, only 4 (13.7%) had an active HCMV infection. In detailed study of the associated laboratory and clinical parameters, cytokine analysis profile, Immuno-histologic findings and rigorous analysis of the investigation reports identified HCMV infection as the probable trigger behind SJS/TEN development in these patients.

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