Emtricitabine is structurally similar to lamivudine, which has been associated with red cell aplasia. We describe four patients with severe anaemia presenting soon after starting emtricitabine-containing antiretroviral therapy. Bone marrow biopsy in three patients confirmed red cell aplasia. Anaemia resolved after emtricitabine withdrawal in three patients, one patient died, and anaemia recurred on rechallenge in one patient whose anaemia persisted on lamivudine, resolving when this was stopped, suggesting a possible cross-reaction between lamivudine and emtricitabine.
aDivision of Clinical Pharmacology
bDepartment of Medicine, University of Cape Town, Cape Town, South Africa.
Correspondence to Karen Cohen, Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa. E-mail: email@example.com
Received 6 November, 2018
Revised 5 December, 2018
Accepted 15 December, 2018