Successful long-course after failure of short-course desensitization in a patient with severe hypersensitivity reaction to enfuvirtide

Enfuvirtide is a milestone in antiretroviral salvage therapy. When combined with a backbone regimen optimized through results of HIV drug resistance testing, it allows virological control to be regained even after many failures. Rare cases of hypersensitivity reactions (HSR) to enfuvirtide have been described, which may limit the possibility to benefit from this drug. Less than 1% patients in the TORO trials experienced HSR to enfuvirtide. Two male patients have so far been reported in the literature, both developing a mild skin reaction, whose recurrence was successfully prevented by short desensitization procedures. It is currently unknown what is the actual pathogenesis of the event and whether a short desensitization procedure could be applied successfully to more severe HSR.