title: Diagnostic accuracy of HLA-B*57:01 screening for the prediction of abacavir hypersensitivity and clinical utility of the test: a meta-analytic review.
abstract: OBJECTIVE
  To determine diagnostic accuracy of HLA-B*57:01 testing for prediction of abacavir-induced hypersensitivity and to quantify the clinical benefit of pretreatment screening through a meta-analytic review of published studies.
  
  
  METHODS
  A comprehensive search was performed up to June 2013. The methodological quality of relevant studies was assessed by the QUADAS-2 tool. The pooled diagnostic estimates were calculated using a random effect model.
  
  
  RESULTS
  Despite the presence of heterogeneity in sensitivity or specificity estimates, the pooled diagnostic odds ratio to detect abacavir-induced hypersensitivity on the basis of clinical criteria was 33.07 (95% CI: 22.33-48.97, I(2): 13.9%), while diagnostic odds ratio for detection of immunologically confirmed abacavir hypersensitivity was 1141 (95% CI: 409-3181, I(2): 0%). Pooled analysis of risk ratio showed that prospective HLA-B*57:01 testing significantly reduced the incidence of abacavir-induced hypersensitivity.
  
  
  CONCLUSIONS
  This meta-analysis demonstrates an excellent diagnostic accuracy of HLA-B*57:01 testing to detect immunologically confirmed abacavir hypersensitivity and corroborates existing recommendations.
authors: Università del Piemonte Orientale "A. Avogadro", Dipartimento di Scienze del Farmaco & Centro di Ricerca Interdipartimentale di Farmacogenetica e Farmacogenomica (CRIFF), Largo Donegani 2, 28100 Novara, Italy.
authors: Sarah
authors: S
authors: Cargnin
authors: Claudio
authors: C
authors: Jommi
authors: Pier Luigi
authors: PL
authors: Canonico
authors: Armando A
authors: AA
authors: Genazzani
authors: Salvatore
authors: S
authors: Terrazzino
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D015224:Dideoxynucleosides / Q000009:adverse effects / Q000627:therapeutic use*; D004342:Drug Hypersensitivity / Q000235:genetics* / Q000473:pathology; D005820:Genetic Testing; D015658:HIV Infections / Q000188:drug therapy / Q000235:genetics*; D015235:HLA-B Antigens / Q000235:genetics*; D006801:Humans; D010597:Pharmacogenetics; D000099227:Abacavir
chemical_list: D019380:Anti-HIV Agents; D015224:Dideoxynucleosides; D015235:HLA-B Antigens; D000099227:Abacavir; C484830:HLA-B*57:01 antigen
keywords: HLA-B*57:01; abacavir hypersensitivity; clinical utility; diagnostic accuracy; meta-analysis