在先前治疗过的HIV-1阳性患者中,对阿巴卡韦过敏反应与HLA-B*5701等位基因存在之间的相关性

Noemí Pérez Prior , Amparo Rocher Milla , Enrique Soler Company , Juan Flores Cid , Benjamín Sarria Chust
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引用次数: 2

摘要

对阿巴卡韦(一种强效逆转录酶抑制剂)的超敏反应是一种严重的不良反应,限制了其在抗逆转录病毒治疗中的应用,需要高水平的临床监测。原组织相容性复合体蛋白(HLA-B*5701)的某些单倍型是对该药过敏风险的非常重要的预测因子。本研究的目的是确定HLA-B*5701等位基因可能出现阿巴卡韦超敏反应的病例。方法在瓦伦西亚卫生局6司对2000年1月至2007年12月期间接受阿巴卡韦治疗的所有HIV-1阳性成年患者进行回顾性研究。收集患者产生的不良反应,以确定哪些病例可能出现临床诊断的过敏反应。最后对39例患者进行HLA-B*5701筛查。结果2000 - 2007年,323例患者接受阿巴卡韦治疗。12.1% (n=39例)出现过敏反应的患者停止治疗。HLA-B*5701阳性9例(23.1%)。8例患者出现皮疹,仅有1例患者出现胃肠道症状和发热。结论应用HLA-B*5701基因检测可预防超敏反应的诊断错误,并能更准确地解释症状,在临床实践中可能是有益的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Correlation, in previously treated HIV-1 positive patients, between hypersensitivity reaction to abacavir and the presence of the HLA-B*5701 allele

Introduction

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.

Method

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.

Results

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.

Conclusions

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.

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