To assess the incidence and the clinical features of the sulfone syndrome associated with dapsone prophylaxis in HIV infected patients. Patients with HIV infection and fewer than 200/uL CD4 cells with severe hypersensitivity reactions occurring within the first month of chemoprophylaxis with dapsone were retrospectively evaluated. Clinical features and laboratory findings of three patients who presented hypersensitivity reaction to dapsone were consistent with the established criteria for the diagnosis of sulfone syndrome. This syndrome has been reported in 1% of HIV patients receiving dapsone 100 mg daily and in 3-6% of patients on multidrug therapy for leprosy. Amongst our patients with HIV infection receiving twice weekly dapsone prophylaxis, the cumulative incidence of sulfone syndrome was 2.5%. The vigilance for the sulfone syndrome should be mantained even during low-dose chemoprophylaxis especially in the first two months of administration.
