H-2293. Is HLA-B*5701 Screening Needed before Starting Abacavir in Every Race?
Session: Poster Session: Antiretroviral Therapy: Complications
Monday, October 27, 2008: 12:00 AM
Room: Hall C
Background: Screening for human leukocyte antigen (HLA)-B*5701 is known to identify the risk patients for hypersensitivity to abacavir. However, there is little data about usefulness of HLA-B*5701 screening test in Asian race. We tried to evaluate the frequency of HLA-B*5701 and its predictive value for abacavir hypersensitivity in Korean patients with HIV infection.
Methods: In 534 Korean HIV patients with available blood samples, HLA-B*5701 was determined by polymerase chain reaction with specific and housekeeping primers, and confirmed by sequence-based typing. Positive and negative controls were included in each test. Among them, medical records of 150 patients who had received abacavir were reviewed. Abacavir hypersensitivity was defined as the case with more than two of fever, rash, gastrointestinal, respiratory or constitutional symptom which disappeared soon after discontinuation of abacavir. Results: None of 534 HIV patients had HLA-B*5701 (95% confidence interval, 0~0.68%). Of the 150 patients receiving abacavir, mean age was 45 ± 11 years, 94% was male and 11% were drug-naïve patients. Mean CD4 count was 452 ± 282 cells/mm3. Fifteen patients (10%) discontinued abacavir within 6 weeks of starting abacavir and 6 patients (4%) met the criteria of abacavir hypersensitivity. None of the patients who discontinued abacavir expressed HLA-B*5701.
Conclusions: HLA-B*5701 was significantly less frequent in HIV-infected Korean than in white and black patients. No patient with clinically suspected abacavir hypersensitivity in this study had HLA-B*5701. These findings strongly suggest that HLA-B*5701 screening test is not cost-effective in Korean HIV patients.
Hee Jang1, Hong Bin Kim, Jae Jeon, MD3, Kang Choe, MD4, Kyung Song1, Myoung Oh1, NAM Kim, MD5, Pyoeng Choe, MD4, Sang Park1, Wan Park, MD, PhD6, Sin Lee1 and  W. B. Park, None., (1)Seoul National University Hospital, (2)Asan Medical Center, Seoul, Korea, Republic of, (3)Seoul National University College of Medicine, Seoul, Korea, Republic of, (4)Departments of Internal Medicine, Seoul, Korea, Republic of, (5)Seoul National University Hospital, Seoul, Korea, Republic of