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Case Reports
. 2019 Sep 23;20(1):983.
doi: 10.4102/sajhivmed.v20i1.983. eCollection 2019.

Emtricitabine-induced pure red cell aplasia

Nithendra Manickchund  1   2 , Camille du Plessis  1   2 , Melanie-Anne A John  2 , Thandekile C Manzini  2 , Bernadett I Gosnell  1   2 , Richard J Lessells  2   3   4 , Yunus S Moosa  1   2
Affiliations
Case Reports

Emtricitabine-induced pure red cell aplasia

Nithendra Manickchund et al. South Afr J HIV Med. .

Abstract

Introduction: Anemia is common in HIV. Parvo B19 infection is a well-recognised cause of red cell aplasia. Other causes of persistent pure red cell aplasia (PRCA) include anti-retroviral drugs such as zidovudine and lamivudine. We describe a case of PRCA that strongly implicates emtricitabine as the probable cause.

Patient presentation: Patient was HIV positive and on treatment with a fixed drug combination consisting of tenofovir, emtricitabine and efavirenz for 3 months when she developed severe transfusion dependent anemia. The anemia, attributed to PRCA, was persistent and transfusion dependent for about one year.

Management and outcome: Replacement of emtricitabine with abacavir resulted in a prompt, complete and lasting resolution of the anaemia, suggesting an etiologic role of emtricitabine in the PRCA.

Conclusion: Emtricitibine is a rare cause of pure red cell aplasia.

Keywords: adverse drug reaction; antiretroviral; drug induced; emtricitabine; pure red cell aplasia; rare drug toxicity.

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Conflict of interest statement

The authors have no conflict of interests.

Figures

FIGURE 1
FIGURE 1
Changes in haemoglobin over time.
See this image and copyright information in PMC

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