Successful cholecalciferol desensitisation in a case of delayed hypersensitivity.

Hypersensitivity to cholecalciferol (vitamin D3) or its active metabolite, calcitriol, is an exceedingly rare clinical phenomenon, with only 2 previously reported cases of suspected immediate hypersensitivity. Diagnosis of delayed drug hypersensitivity reactions is inherently difficult due to the lack of any robust in vitro diagnostic assay, particularly in those patients for whom provocation testing confers an unacceptable risk. In these situations, diagnosis relies on reproducible clinical manifestations following administration of the culprit agent, resolution upon its withdrawal and exclusion of other potential differential diagnoses. Based on these criteria, we propose the first reported case of delayed hypersensitivity to cholecalciferol successfully managed with a desensitisation protocol to pure cholecalciferol.

Complementary medicine use by people living with HIV in Australia - a national survey.

Little is known about the use of complementary medicines by people living with HIV in Australia since the advent of more effective combination antiretroviral therapy. We conducted an anonymous survey of 1211 adult patients receiving combination antiretroviral therapy from one of eight specialist HIV clinics across Australia, aiming to identify the current patterns of use of ingestible complementary medicines. Data collected included reasons for use, information sources and rates of disclosure of use of complementary medicines to medical practitioners and pharmacists. Ingestible complementary medicine was used by up to 53% of the 1037 patients returning a survey. Complementary medicine was commonly used for general health, to boost immune function and, to a lesser extent, to address co-morbidities. Disclosure of complementary medicines use to doctors was far higher than to pharmacists. Given the potential for interactions, pharmacists should be more aware of patients' complementary medicines use.