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July 4, 2006 (Reuters Health)—In a study of HIV-infected patients living in Western Australia, screening for HLA-B*5701, the major factor implicated in abacavir hypersensitivity, was useful in preventing the side effect.
Up to 8% of patients treated with abacavir therapy will experience a significant hypersensitivity reaction, Dr. Simon Mallal, from the Royal Perth Hospital in Western Australia, and colleagues note. Repeat treatment of such individuals with abacavir can have serious, even lethal, consequences.
In the present study, reported in the July 1st issue of Clinical Infectious Diseases, the researchers assessed the value of HLB-B*5701 screening in 260 abacavir-naïve patients who were initiating or changing antiretroviral therapy from January 2002 to July 2005.
Twenty patients (7.7%) tested positive for the HLB-B*5701 allele. Of the remaining 240 patients, 148 were treated with a regimen that included abacavir and no hypersensitivity reactions were noted.
"Prospective genetic screening with avoidance of abacavir prescription in patients carrying the susceptibility marker HLA-B*5701 has had a dramatic impact on the incidence of abacavir hypersensitivity in the Western Australian HIV Cohort," the authors conclude.
In a related editorial, Dr. Elizabeth J. Phillips, from St. Paul's Hospital in Vancouver, Canada, comments that HLA-B*5701 screening also appears to be cost effective "both by lowering the morbidity associated with true hypersensitivity reactions and by reducing inappropriate early discontinuation of therapy."
