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HLA-B*5701 Typing

HLA-B*5701 Typing

Test Highlight

HLA-B*5701 Typing

  

Clinical Use

  • Guide selection of antiretroviral drugs

  • Assess risk of hypersensitivity reaction to abacavir therapy

Clinical Background

Abacavir therapy is used to treat patients with HIV infection; however, it is associated with significant risk (2% to 9% of cases) of hypersensitivity reaction.1 Such reactions are typically characterized by skin rash, fever, malaise, nausea and other gastrointestinal symptoms, dyspnea, cough, and other respiratory symptoms. Life-threatening symptoms occur with less frequency and may include anaphylaxis and liver, kidney, or respiratory failure.1

Researchers have confirmed that a specific human genetic variation, known as HLA-B*5701, is associated with susceptibility to abacavir hypersensitivity.2,3 Pharmacogenetic screening for the HLA-B*5701 allele is recommended for abacavir-naïve patients and before reinitiation of abacavir treatment.1,4-6 Selection of a non-abacavir regimen would then be recommended for patients with the HLA-B*5701 allele.

Thus, HLA-B*5701 testing has the potential to significantly improve patient care by allowing for a more informed use of abacavir treatment.7

Method

This test uses polymerase chain reaction (PCR) followed by hybridization with sequence-specific oligonucleotide probes to detect the HLA-B*5701 allele.

Interpretive Information

Presence of the HLA-B*5701 allele indicates the patient is at high risk of abacavir hypersensitivity reaction.1

References

  1. Ziagen® [prescribing information®. Research Triangle Park, NC: GlaxoSmithKline; 2008.

  2. Mallal S, Nolan D, Witt C, et al. Association between presence of HLA-B*5701, HLA-DR7, and HLA-DQ3 and hypersensitivity to HIV-1 reverse-transcriptase inhibitor abacavir. Lancet. 2002;359:727-732.

  3. Rauch A, Nolan D, Martin A, et al. Prospective genetic screening decreases the incidence of abacavir hypersensitivity reactions in the Western Australian HIV cohort study. Clin Inf Dis. 2006;43:99-102.

  4. FDA Alert [7/24/2008]. Information on Abacavir (marketed as Ziagen) and abacavir-containing medications. Available at: http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsand
    Providers/ucm094302.htm. Accessed June 19, 2009.

  5. Mallal, S, Phillips E, Carosi G, et al. HLA-B*5701 screening for hypersensitivity to abacavir. N Engl J Med. 2008;358:568-579.

  6. Saag M, Balu R, Phillips E, et al. High sensitivity of human leukocyte antigen-b*5701 as a marker for immunologically confirmed abacavir hypersensitivity in white and black patients. Clin Infect Dis. 2008;46:1111-1118.

  7. Phillips EJ. Genetic screening to prevent abacavir hypersensitivity reaction: are we there yet? Clin Inf Dis. 2006;43:103-105.
     

Content reviewed 12/2011
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