Association between the HLA-B*15:02 allele and carbamazepine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis in Han individuals of northeastern China

Pharmacol Rep. 2013;65(5):1256-62. doi: 10.1016/s1734-1140(13)71483-x.

Abstract

Background: This study examined the significant association between carbamazepine (CBZ)-induced Stevens-Johnson Syndrome (SJS)/toxic epidermal necrolysis (TEN) and HLA-B*15:02 in epilepsy patients of Han ethnicity living in northeastern China.

Methods: CBZ-SJS/TEN patients and CBZ-tolerant control patients were genotyped for HLA-B*15:02 by PCR amplification using sequence-specific primers. Patients then were evaluated for HLA genotypes using PCR with sequence-based typing.

Results: Eight of 35 CBZ-SJS/TEN patients carried HLA-B*15:02 (22.9%) versus 2 of 125 in CBZ-tolerant control patients (OR = 18.222, 95% CI = 3.662-90.662, p = 0.000). Our results suggest that HLA-B*15:02 is necessary but is not sufficient to produce SJS/TEN following CBZ treatment among Han individuals from northeastern China. Other HLA alleles, including A*33:03, B*58:01, C*03:02, DQB1*03:03, and DRB1*07:01 may be associated weakly with CBZ-SJS/TEN.

Conclusions: Our results are not consistent with previous studies reporting a strong association between HLA-B*15:02 and CBZ-SJS/TEN among individuals from southern, southwestern, and central China. Other genes may be more tightly associated with CBZ-SJS/TEN. Screening for HLA-B*15:02 still may be recommended for patients in northeastern China before starting CBZ.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anticonvulsants / adverse effects*
  • Asian People / genetics*
  • Carbamazepine / adverse effects*
  • Case-Control Studies
  • Child
  • China / epidemiology
  • Female
  • Gene Frequency
  • Genetic Predisposition to Disease
  • HLA-B15 Antigen / genetics*
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Phenotype
  • Polymerase Chain Reaction
  • Risk Factors
  • Sequence Analysis, DNA
  • Stevens-Johnson Syndrome / ethnology
  • Stevens-Johnson Syndrome / genetics*
  • Stevens-Johnson Syndrome / immunology
  • Young Adult

Substances

  • Anticonvulsants
  • HLA-B*15:02 antigen
  • HLA-B15 Antigen
  • Carbamazepine