Dapsone interferes with hemoglobin A1c monitoring of diabetes in an HIV-infected patient

摘要

A 58-year old man with diabetes was seen in HIV clinic for routine outpatient care. He was diagnosed with HIV 7 years previously, with an initial CD4 cell count of 77 cells/|xl, and was also concurrently diagnosed with Burkitt's lymphoma. He initiated HIV treatment with a combination tablet of efavirenz/emtricitabine/tenofovir,. quickly had an undetectable viral load, and tolerated his antiretroviral medication well. He also started Pneumocystis prophylaxis with trimethoprim-sulfamethoxazole (TMP-SMX). He then underwent extensive chemotherapy for Burkitt's lymphoma and eventually achieved a complete remission. During chemotherapy, he had several episodes of pancytopenia; TMP-SMX prophylaxis was changed to dapsone to promote hematologic recovery. Postcancer treatment, his CD4 count was slow to recover but, 7 years after starting therapy, the physician recommended discontinuation of dapsone for Pneumocystis prophylaxis because his CD4 count was more than 200 cells/|xl on two consecutive measurements spanning 12 months.