GlaxoSmithKline, Research Triangle Park, North Carolina 27709-3398, USA.
AIDS Patient Care STDS. 2009 Nov;23(11):957-63. doi: 10.1089/apc.2008.0245.
Screening for HLA-B 5701 reduces the risk of developing an abacavir hypersensitivity reaction (ABC HSR) and is recommended in all patients before initiating highly active antiretroviral therapy (HAART) with abacavir. Between September 2007 and March 2008 we conducted a study of the attitudes and practice patterns of HIV providers in the United States to identify barriers to HLA-B 5701 testing in clinical practice. Study participants who completed an educational program could receive HLA-B 5701 test kits for use in their clinical practice. Surveys were administered before and after the educational program. A total of 477 HIV providers registered to participate in the survey, and 134 providers tested a total of 874 HIV-infected subjects, of which 6% (49/874) were HLA-B 5701 positive. Of 433 providers who completed the preeducation survey, 97% indicated that the test provided clinical value and 77% anticipated barriers to testing, with cost/reimbursement the most frequently cited. Among 202 providers who completed the posteducation survey, perceptions of the test's value remained largely unchanged while the proportion of providers who anticipated or encountered barriers to testing decreased. Of providers who used HLA-B 5701 test kits, 86% (115/134) found it "very easy" or "easy" to obtain test results, 95% (127/134) found it "very easy" or "easy" to interpret results, and 89% (119/134) indicated that they planned to continue HLA-B 5701 testing after the study. The results of this study suggest that HLA-B 5701 testing is easy to use in clinical practice and is a valuable tool to help reduce the risk of developing ABC HSR.
对 HLA-B 5701 的筛查可降低发生阿巴卡韦过敏反应（ABC HSR）的风险，因此建议在开始用阿巴卡韦进行高效抗逆转录病毒治疗（HAART）前，对所有患者进行 HLA-B 5701 检测。2007 年 9 月至 2008 年 3 月期间，我们开展了一项研究，旨在调查美国 HIV 医护人员的态度和实践模式，以确定 HLA-B 5701 检测在临床实践中的障碍。完成教育项目的研究参与者可获得 HLA-B 5701 检测试剂盒，用于他们的临床实践。在教育项目前后进行了调查。共有 477 名 HIV 医护人员注册参加调查，其中 134 名医护人员共对 874 名 HIV 感染者进行了检测，其中 6%（49/874）为 HLA-B 5701 阳性。在完成预教育调查的 433 名医护人员中，97%表示该检测具有临床价值，77%预计会有检测障碍，其中费用/报销是最常被提及的障碍。在完成后续教育调查的 202 名医护人员中，他们对检测的价值的看法基本保持不变，而预计或遇到检测障碍的医护人员比例有所下降。在使用 HLA-B 5701 检测试剂盒的医护人员中，86%（115/134）认为获得检测结果“非常容易”或“容易”，95%（127/134）认为解释结果“非常容易”或“容易”，89%（119/134）表示他们计划在研究结束后继续进行 HLA-B 5701 检测。这项研究的结果表明，HLA-B 5701 检测在临床实践中易于使用，是帮助降低发生 ABC HSR 风险的有价值工具。
