An epidemiologic study to determine the prevalence of the HLA-B*5701 allele among HIV-positive patients in Europe.
OBJECTIVE
HLA-B*5701 is a major histocompatibility complex class I allele associated with an immunologically-mediated hypersensitivity reaction to abacavir. The objectives of this study were to evaluate HLA-B*5701 prevalence among European, HIV-1-infected patients and to compare the local and central laboratory screening results.


METHODS
Data were combined from six multicentre, prospective studies involving 10 European countries in which HIV-1-infected patients (irrespective of treatment experience or previous HLA-B*5701 screening), >or=18 years of age, were evaluated for HLA-B*5701 carriage, determined by the central and local laboratory methods.


RESULTS
A total of 9720 patients from 272 centres were included in the analysis. The overall estimate of HLA-B*5701 prevalence in Europe was 4.98%, with country-specific estimates ranging from 1.53 to 7.75%. HLA-B*5701 prevalence was highest in the self-reported white population (6.49%) and lowest in the black population (0.39%). Local laboratory results had a high specificity (99.9%) and sensitivity (99.2%) when compared with the central laboratory results.


CONCLUSIONS
This study supports data from previous studies regarding the prevalence of HLA-B*5701 in the HIV population and the variation of HLA-B*5701 prevalence between different racial groups. The high specificity and sensitivity of local laboratory results, suggests that clinicians can be confident in using local laboratories for pretreatment HLA-B*5701 screening. However, it is essential that local laboratories participate in HLA-B*5701-specific quality assurance programs to maintain 100% sensitivity. In HIV-infected patients, pretreatment HLA-B*5701 screening may allow more informed decisions regarding abacavir use and has the potential to significantly reduce the frequency of abacavir-related hypersensitivity reactions and costs associated with managing these reactions.
Orkin
Chloe
C
Barts and The London NHS Trust, London, UK. orkin.chloe@bartsandthelondon.nhs.uk
Wang
Jianmin
J
Bergin
Colm
C
Molina
Jean-Michel
JM
Lazzarin
Adriano
A
Cavassini
Matthias
M
Esser
Stefan
S
Gómez Sirvent
Juan-Luis
JL
Pearce
Helen
H
D000328:Adult; D000483:Alleles; D005060:Europe; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000235:genetics*; D006679:HIV Seropositivity; D015235:HLA-B Antigens / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012680:Sensitivity and Specificity
D015235:HLA-B Antigens; C484830:HLA-B*57:01 antigen