Original research article
Porto Biomed. J. 2017; 2(2): 59-62 doi: http://dx.doi.org/doi:10.1016/j.pbj.2016.12.004 (Published 4 February 2017)

Prevalence of abacavir-associated hypersensitivity syndrome and HLA-B*5701 allele in a Portuguese HIV-positive population

Fabrícia Carolinoa,*, Natacha Santosa, Carmela Piñeirob, Ana Sofia Santosb, Pedro Soaresc, António Sarmentob, Josefina Rodrigues Cernadasa 

Serviço de Imunoalergologia, Centro Hospitalar São João, E.P.E., Porto, Portugal
Serviço de Doenças Infecciosas, Centro Hospitalar São João, E.P.E., Porto, Portugal
Serviços Farmacêuticos, Centro Hospitalar São João, E.P.E., Porto, Portugal
*Corresponding author:
Accepted 17 December 2016
Background: Human Immunodeficiency Virus (HIV)-positive patients treated with the antiretroviral drug abacavir (ABC) may develop a potentially fatal ABC-associated hypersensitivity syndrome (ABC-HS), typically characterized by fever, malaise, rash, vomiting/diarrhoea and/or dyspnoea/cough. ABC-HS has been strongly associated with HLA-B*57:01 carriage and screening for this allele is recommended. Objective: To determine the prevalence of HLA-B*57:01 and to characterize suspected ABC-HS in the adult HIV population from our hospital during a 7-year period. Methods: Clinical data on patients under ABC treatment from January 2006 to December 2012 were analyzed to search for symptoms of ABC-HS. Reactions of suspected ABC-HS were characterized. HLA-B*57:01 and patch tests (1% and 10% ABC in petrolatum) with readings at 48 h were performed in those without previous testing. From January 2008 routine HLA-B*57:01 screening was implemented. Results: From January 2006 to December 2007, 186 patients began treatment with ABC (data from 163 were available): 7 (4%) patients stopped ABC for suspected ABC-HS (71% males, median age 45 years) and the median time for onset of the reaction after starting ABC was 7 days. Four of the 7 patients had the HLA-B*57:01 allele and 2 of these 4 had positive patch tests. After HLA-B*57:01 screening implementation (January 2008), 573 patients were evaluated and 35 (6.1%) were HLA-B*57:01 positive; no suspected ABC-HS were observed since then. Conclusion: Four patients with suspected ABC-HS (of 6 screened) were HLA-B*57:01 positive. No ABC-HS occurred since January 2008, after HLA-B*57:01 screening was implemented.

Abbreviations: ABC, abacavir; ABC-HS, abacavir-associated hypersensitivity syndrome; ART, antiretroviral therapy; HIV, Human Immunodeficiency Virus; IQR, interquartile range; NRTI, nucleoside reverse transcriptase inhibitors
Abacavir; Antiretroviral therapy; Drug hypersensitivity; HIV; HLA-B*57:01
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