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document
Pruritus in HIV-1 disease : therapy with drugs which may modulate the pattern of immune dysregulation . BACKGROUND Pruritus in HIV-1+ patients is common and increases with disease progression . The causes of pruritus are numerous including xerosis , drug and photoeruptions , follicular and papular eruptions as well as infestations and infections by a wide range of organisms . One other possible factor contributing to pruritus is the pattern of immune dysregulation . With advancing HIV-1 disease there is Th1 to Th2 cytokine switching . METHODS After some positive results with prostaglandin inhibitors , we undertook a study in which we randomly placed patients on four different forms of therapy for their pruritus . The therapies included hydroxyzine with or without doxepin at night , pentoxifylline , indomethacin and topical moisturization with medium-strength topical steroids . All patients were evaluated for both subjective relief as well as side effects . RESULTS Patients placed on indomethacin obtained relief more consistently and more completely . Patients on pentoxifylline had the fewest side effects of all oral therapies . Patients on antihistamines with or without doxepin had the highest incidence of side effects , although more of these patients reported a greater degree of relief than patients on pentoxifylline . All patients on oral therapy overall had greater relief than patients using topical steroids . CONCLUSION The systemic therapies which may modulate the pattern of immune dysregulation seen in HIV-1 disease may be beneficial in the pruritus seen in late-stage patients .
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Intervention_Pharmacological
hydroxyzine with or without doxepin at night
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Intervention_Pharmacological
pentoxifylline
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Intervention_Pharmacological
indomethacin and topical moisturization with medium-strength topical steroids
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Outcome_Physical
immune dysregulation
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Outcome_Other
subjective relief
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Outcome_Adverse-effects
side effects
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Outcome_Other
relief
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Outcome_Adverse-effects
side effects
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Outcome_Adverse-effects
incidence of side effects
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Outcome_Other
degree of relief
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Outcome_Other
greater relief
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Outcome_Physical
immune dysregulation
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Outcome_Other
beneficial
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Participant_Condition
Pruritus
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Participant_Condition
HIV-1+
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Participant_Condition
four different forms of therapy
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Participant_Condition
pruritus