Successful implementation of a national HLA-B*5701 genetic testing service in Canada

Tissue Antigens. 2010 Jan;75(1):12-8. doi: 10.1111/j.1399-0039.2009.01383.x. Epub 2009 Oct 15.

Abstract

Abacavir is a nucleoside reverse transcriptase inhibitor (NRTI) that is used in combination antiretroviral therapy in HIV-infected patients. It is currently recommended as a preferred or an alternative NRTI in antiretroviral-naïve patients. The major toxicity of abacavir is a hypersensitivity reaction (HSR), which occurs in approximately 5% of treated patients. There is a strong association between the human leukocyte antigen (HLA)-B*5701 allele and abacavir HSR, which has allowed for rapid acceptance of genetic screening for HLA-B*5701 in clinical use. Canadian clinicians working in hospital centers with HLA typing capacity opted to launch a pilot project in 2006 to offer the screening test as standard of care to HIV-infected patients. Currently, more than 11,000 HLA-B*5701 tests have been performed, among which 6.3% are positive. Continued efforts have been made to ensure that testing is available to all HIV-infected patients to widen the patients' therapeutic options. HLA-B*5701 screening shows clinical use and preliminary data suggest cost-effectiveness.

MeSH terms

  • Alleles
  • Anti-HIV Agents / adverse effects*
  • Anti-HIV Agents / therapeutic use
  • Canada
  • Cost-Benefit Analysis
  • Dideoxynucleosides / adverse effects*
  • Dideoxynucleosides / therapeutic use
  • Drug Hypersensitivity / genetics*
  • Drug Hypersensitivity / immunology
  • Genetic Testing / economics
  • HIV Infections / drug therapy
  • HIV Infections / economics
  • HIV Infections / genetics*
  • HIV Infections / immunology
  • HLA-B Antigens / genetics*
  • HLA-B Antigens / immunology
  • Humans
  • Randomized Controlled Trials as Topic
  • Reverse Transcriptase Inhibitors / adverse effects
  • Reverse Transcriptase Inhibitors / therapeutic use

Substances

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