title: Detection of abacavir hypersensitivity by ELISpot method.
abstract: The antiretroviral agent abacavir can cause hypersensitivity reaction (HSR) and the presence of HLA-B*57:01 is predictive of abacavir-HSR in Caucasian HIV-infected patients. However, abacavir-HSR also occurs in HLA-B*57:01 negative patients. In these patients, a safe diagnostic tool to dissect clinically suspected HSR against abacavir from adverse reactions against co-administered drugs is mandatory, and abacavir-ELISpot was evaluated. Peripheral blood mononuclear cells from 87 HIV patients were stimulated by abacavir and the production of interferon-γ to the ELISpot was determined. Abacavir treated patients with HSR [confirmed (n=5) or suspected (n=12)] vs without HSR (n=42) displayed significantly higher numbers of abacavir-specific cells (82.3±23.0 or 10.5±4.5 vs -0.5±1.0 spot forming cells per million PBMC, p < .005 each). In conclusion, we established the first abacavir-specific ELISpot. According to our preliminary data, a negative abacavir-ELISpot nearly excludes HSR against abacavir. Thereby the ELISpot may facilitate the decision to continue or withdraw abacavir treatment.
authors.affiliation: HIV/STD-Out Patient Clinic, Department of Dermatology and Venerology, University Hospital Essen, Essen, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Esser
authors.forename: Robert
authors.initials: R
authors.lastname: Jablonka
authors.forename: Falko M
authors.initials: FM
authors.lastname: Heinemann
authors.forename: Stefan
authors.initials: S
authors.lastname: Reuter
authors.forename: Hans
authors.initials: H
authors.lastname: Jaeger
authors.forename: Ariane
authors.initials: A
authors.lastname: von Krosigk
authors.forename: Pia
authors.initials: P
authors.lastname: Schenk-Westkamp
authors.forename: Dirk
authors.initials: D
authors.lastname: Schadendorf
authors.forename: Peter A
authors.initials: PA
authors.lastname: Horn
authors.forename: Monika
authors.initials: M
authors.lastname: Lindemann
mesh_terms: D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002170:Canada; D015224:Dideoxynucleosides / Q000009:adverse effects* / Q000627:therapeutic use; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000209:etiology; D058501:Enzyme-Linked Immunospot Assay / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D015235:HLA-B Antigens / Q000235:genetics; D006801:Humans; D007371:Interferon-gamma / Q000276:immunology; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D000099227:Abacavir
chemical_list: D019380:Anti-HIV Agents; D015224:Dideoxynucleosides; D015235:HLA-B Antigens; D007371:Interferon-gamma; D000099227:Abacavir; C484830:HLA-B*57:01 antigen