HLA-B*5701 screening for susceptibility to abacavir hypersensitivity.
The introduction of highly active antiretroviral therapy (also known as combination therapy) has transformed the nature of HIV infection from a severe and ultimately fatal disease to that of a manageable chronic condition. HIV drugs are highly efficacious, but their use comes at the cost of a range of drug-related adverse events, including severe drug hypersensitivity reactions (HSRs) that have been most notably associated with abacavir and nevirapine therapy. This article discusses the issues of pharmacogenetic screening, in the light of the strong genetic association of the HLA-B*5701 allele and the susceptibility to developing abacavir HSRs. It also presents the screening's impact on clinical practice and discusses the practical considerations that influence the introduction and cost-effectiveness of such screening.
Lucas
Andrew
A
Centre for Clinical Immunology and Biomedical Statistics, Royal Perth Hospital and Murdoch University, Level 2, North Block, Wellington Street, Perth, WA 6000, Australia.
Nolan
David
D
Mallal
Simon
S
D000483:Alleles; D019380:Anti-HIV Agents / Q000009:adverse effects*; D015224:Dideoxynucleosides / Q000009:adverse effects*; D004353:Drug Evaluation, Preclinical; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000235:genetics*; D005820:Genetic Testing; D015658:HIV Infections / Q000150:complications* / Q000235:genetics; D015497:HIV-1; D015235:HLA-B Antigens / Q000235:genetics*; D006801:Humans; D010597:Pharmacogenetics; D011237:Predictive Value of Tests; D000099227:Abacavir
D019380:Anti-HIV Agents; D015224:Dideoxynucleosides; D015235:HLA-B Antigens; D000099227:Abacavir; C484830:HLA-B*57:01 antigen