Current trends in screening across ethnicities for hypersensitivity to abacavir.
Abacavir is a potent nucleoside analog reverse transcriptase inhibitor approved for the treatment of HIV infection. Approximately 5-8% of Caucasian patients receiving abacavir develop a hypersensitivity reaction, characterized by rash, fever and, occasionally, multisystemic involvement. Rechallenge with the drug can be fatal. The discovery of the mechanisms involved in this hypersensitivity reaction and the identification of tools for its prediction are the subject of this review. The most relevant finding is the recognition of a strong association between one specific haplotype at the HLA complex type I, HLA-B*5701, and the abacavir hypersensitivity reaction. The heterogeneity in the prevalence of HLA-B*5701 across distinct ethnicities accounts for differences in the risk of abacavir hypersensitivity reactions in distinct populations.
Department of Pharmacokinetics and Pharmacogenomics, Hospital Carlos III, Calle Sinesio Delgado 10, Madrid 28029, Spain. sonia_r_novoa@hotmail.com
Sonia
S
Rodriguez-Nóvoa
Vincent
V
Soriano
D000483:Alleles; D019380:Anti-HIV Agents / Q000009:adverse effects; D015224:Dideoxynucleosides / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000208:ethnology* / Q000235:genetics* / Q000517:prevention & control; D005544:Forecasting; D005820:Genetic Testing / Q000639:trends*; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology; D015235:HLA-B Antigens / Q000235:genetics; D006239:Haplotypes; D006801:Humans; D018448:Models, Immunological; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D012307:Risk Factors; D012680:Sensitivity and Specificity; D000099227:Abacavir
D019380:Anti-HIV Agents; D015224:Dideoxynucleosides; D015235:HLA-B Antigens; D018894:Reverse Transcriptase Inhibitors; D000099227:Abacavir; C484830:HLA-B*57:01 antigen