Sun Hsin-Yun, Hung Chien-Ching, Lin Pi-Han, Chang Shu-Fang, Yang Ching-Yao, Chang Sui-Yuan, Chang Shan-Chwen
Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan.
J Antimicrob Chemother. 2007 Sep;60(3):599-604. doi: 10.1093/jac/dkm243. Epub 2007 Jul 12.
To describe the incidence of hypersensitivity to abacavir and frequency of human leucocyte antigen (HLA)-B*5701 in HIV-infected Taiwanese persons.
Medical records of 337 HIV-infected Taiwanese in whom abacavir-containing combination antiretroviral therapy (CART) was prescribed from 1 May 2001 to 31 December 2006 were reviewed, and HLA typing of the patients was performed in 320 patients (232 receiving abacavir and 88 not receiving abacavir) with available blood samples. HLA class I and II polymorphisms were determined by PCR with specific primers. HLA-B*5701 was further confirmed by sequence-based typing.
Of the 337 patients, median CD4 count was 166.5 cells/mm3 (range, 1.0-1914.0) and 83 patients (24.6%) had AIDS-defining opportunistic infections. Thirty-eight patients (11.3%) discontinued abacavir within 6 weeks of starting abacavir-containing CART. Among them, 10 patients had successful abacavir re-challenge and another 11 patients had other specific reasons for abacavir discontinuation. Therefore, 14 patients (4.2%) were classified as cases in whom abacavir hypersensitivity could not be excluded, and 3 patients (0.9%) met the criteria of abacavir hypersensitivity. Of the 320 patients undergoing HLA typing, HLA-A02 was the most common allele and only one individual (0.3%) expressed HLA-B*5701. Along with some differences in allele distributions, there was a significant difference in the genetic frequency of HLA-B57 in our patients compared with those of previous studies in other Chinese populations.
Abacavir hypersensitivity was less frequently encountered in HIV-infected Taiwanese initiating abacavir-containing CART than in Caucasians, which might be explained by the low frequency of the HLA-B*5701 allele.
描述台湾地区HIV感染者中对阿巴卡韦过敏的发生率以及人类白细胞抗原（HLA）-B*5701的频率。
回顾了2001年5月1日至2006年12月31日期间接受含阿巴卡韦的联合抗逆转录病毒治疗（CART）的337例台湾地区HIV感染者的病历，并对320例患者（232例接受阿巴卡韦治疗，88例未接受阿巴卡韦治疗）进行了HLA分型，这些患者均有可用的血样。通过使用特异性引物的聚合酶链反应（PCR）确定HLA I类和II类多态性。通过基于序列的分型进一步确认HLA-B*5701。
337例患者中，CD4细胞计数中位数为166.5个/mm³（范围为1.0 - 1914.0），83例患者（24.6%）发生了定义艾滋病的机会性感染。38例患者（11.3%）在开始含阿巴卡韦的CART治疗6周内停用了阿巴卡韦。其中，10例患者成功重新挑战使用阿巴卡韦，另外11例患者因其他特定原因停用阿巴卡韦。因此，14例患者（4.2%）被归类为不能排除阿巴卡韦过敏的病例，3例患者（0.9%）符合阿巴卡韦过敏标准。在进行HLA分型的320例患者中，HLA-A02是最常见的等位基因，只有1例个体（0.3%）表达HLA-B*5701。除了等位基因分布存在一些差异外，与之前其他中国人群的研究相比，我们患者中HLA-B57的基因频率存在显著差异。
与白种人相比，台湾地区开始含阿巴卡韦CART治疗的HIV感染者中阿巴卡韦过敏的发生率较低，这可能是由于HLA-B*5701等位基因频率较低所致。
