Novel sensitive, specific and rapid pharmacogenomic test for the prediction of abacavir hypersensitivity reaction: HLA-B*57:01 detection by real-time PCR

Pharmacogenomics. 2011 Apr;12(4):567-76. doi: 10.2217/pgs.10.208.

Abstract

Aim: International HIV treatment guidelines recommend HLA-B*57:01 typing before abacavir administration, in order to reduce the incidence of abacavir hypersensitivity reactions, the major cause of early therapy discontinuation. A fast, sensitive and specific test for HLA-B*57:01 detection has been developed in the present study.

Materials & methods: Two sets of sequence-specific primers were designed, and amplification rapidly detected by real-time PCR.

Results: A total of 108 samples were analyzed in a single-blind fashion, and 41 samples were identified as positive. Complete agreement, with κ = 1 (standard error = 0.0962, p < 0.0001), was found, with a validated methodology used in the EPI109367 clinical trial funded by GlaxoSmithKline, and consisting of low-resolution sequence-specific oligonucleotide PCR, followed by high-resolution sequence-specific oligonucleotide PCR carried out on the HLA-B*57-positive samples.

Conclusion: We provided a detailed characterization of a novel HLA-B*57:01 screening test, which can be easily implemented by those laboratories already involved in the detection of viral load and virus genotyping. Original submitted 26 October 2010; Revision submitted 13 December 2010.

MeSH terms

  • Anti-HIV Agents / adverse effects*
  • Anti-HIV Agents / therapeutic use
  • Base Sequence
  • Dideoxynucleosides / adverse effects*
  • Dideoxynucleosides / therapeutic use
  • Drug Hypersensitivity / blood
  • Drug Hypersensitivity / diagnosis*
  • Drug Hypersensitivity / genetics*
  • HIV Infections / drug therapy
  • HLA-B Antigens / blood
  • HLA-B Antigens / genetics*
  • Humans
  • Molecular Sequence Data
  • Pharmacogenetics
  • Polymerase Chain Reaction / methods*

Substances

  • Anti-HIV Agents
  • Dideoxynucleosides
  • HLA-B Antigens
  • HLA-B*57:01 antigen
  • abacavir