Correlation, in previously treated HIV-1 positive patients, between hypersensitivity reaction to abacavir and the presence of the HLA-B5701 allele

• Published in: Farmacia hospitalaria 2009-05, Vol.33 (3), p.155
• Main Authors: Pérez Prior, Noemí, Rocher Milla, Amparo, Soler Company, Enrique, Flores Cid, Juan, Sarria Chust, Benjamín
• Format: Article
• Language: Spanish
• Subjects: Adult; Aged; Anti-HIV Agents - adverse effects; Anti-HIV Agents - therapeutic use; Dideoxynucleosides - adverse effects; Dideoxynucleosides - therapeutic use; Drug Eruptions - etiology; Drug Eruptions - genetics; Female; Fever - chemically induced; Gastrointestinal Diseases - chemically induced; Genes, MHC Class I; Genetic Predisposition to Disease; Genotype; HIV Infections - drug therapy; HIV-1; HLA-B Antigens - genetics; Humans; Male; Middle Aged; Retrospective Studies; Reverse Transcriptase Inhibitors - adverse effects; Reverse Transcriptase Inhibitors - therapeutic use
• ISSN: 1130-6343

Hypersensitivity reaction to abacavir (a powerful inverse transcriptase inhibitor) is a serious adverse effect that limits its use in antiretroviral treatment and requires a high level of clinical surveillance. Certain haplotypes of the primary histocompatibility complex proteins (HLA-B*5701) are very significant predictors of the risk of hypersensitivity to this drug. The purpose of this study is to identify the cases where a probable hypersensitivity reaction to abacavir presented the HLA-B*5701 allele. A retrospective study was conducted in all HIV-1 positive adult patients infected treated with abacavir between January 2000 and December 2007, in Department 6 of the Agencia Valenciana de Salud (Valencia Health Agency). The adverse effects developed by the patients were collected to determine which cases presented a probable clinically diagnosed hypersensitivity reaction. Finally, these 39 patients were screened for HLA-B*5701. In total, 323 patients were treated with abacavir between 2000 and 2007. The treatment was discontinued in 12.1 % (n = 39 patients) presenting a hypersensitivity reaction. Nine (23.1 %) of these were HLA-B*5701 positive. Eight patients presented skin rash and positivity was observed in only single patient with gastrointestinal symptoms and fever. The administration of the HLA-B*5701 gene test may be of benefit in clinical practice, because it prevents diagnostic errors of the hypersensitivity reaction and enables more accurate interpretation of the symptoms.