Barts and The London NHS Trust, London, UK.
Pharmacogenet Genomics. 2010 May;20(5):307-14. doi: 10.1097/FPC.0b013e3283390666.
HLA-B5701 is a major histocompatibility complex class I allele associated with an immunologically-mediated hypersensitivity reaction to abacavir. The objectives of this study were to evaluate HLA-B5701 prevalence among European, HIV-1-infected patients and to compare the local and central laboratory screening results.
Data were combined from six multicentre, prospective studies involving 10 European countries in which HIV-1-infected patients (irrespective of treatment experience or previous HLA-B5701 screening), >or=18 years of age, were evaluated for HLA-B5701 carriage, determined by the central and local laboratory methods.
A total of 9720 patients from 272 centres were included in the analysis. The overall estimate of HLA-B5701 prevalence in Europe was 4.98%, with country-specific estimates ranging from 1.53 to 7.75%. HLA-B5701 prevalence was highest in the self-reported white population (6.49%) and lowest in the black population (0.39%). Local laboratory results had a high specificity (99.9%) and sensitivity (99.2%) when compared with the central laboratory results.
This study supports data from previous studies regarding the prevalence of HLA-B5701 in the HIV population and the variation of HLA-B5701 prevalence between different racial groups. The high specificity and sensitivity of local laboratory results, suggests that clinicians can be confident in using local laboratories for pretreatment HLA-B5701 screening. However, it is essential that local laboratories participate in HLA-B5701-specific quality assurance programs to maintain 100% sensitivity. In HIV-infected patients, pretreatment HLA-B*5701 screening may allow more informed decisions regarding abacavir use and has the potential to significantly reduce the frequency of abacavir-related hypersensitivity reactions and costs associated with managing these reactions.
HLA-B5701 是与阿巴卡韦免疫介导的过敏反应相关的主要组织相容性复合体 I 等位基因。本研究的目的是评估欧洲 HIV-1 感染患者中 HLA-B5701 的流行率，并比较当地和中央实验室的筛查结果。
合并了来自六个涉及 10 个欧洲国家的多中心前瞻性研究的数据，这些研究纳入了年龄≥18 岁的 HIV-1 感染患者（无论治疗经验或之前是否进行过 HLA-B5701 筛查），通过中央和当地实验室方法评估 HLA-B5701 携带情况。
共纳入了来自 272 个中心的 9720 名患者。欧洲 HLA-B5701 流行率的总体估计值为 4.98%，各国的估计值范围为 1.53%至 7.75%。在自我报告的白人人群中 HLA-B5701 的流行率最高（6.49%），而在黑人人群中最低（0.39%）。与中央实验室结果相比，当地实验室结果具有很高的特异性（99.9%）和敏感性（99.2%）。
本研究支持了之前研究中关于 HIV 人群中 HLA-B5701 流行率以及不同种族群体之间 HLA-B5701 流行率差异的研究数据。当地实验室结果的高特异性和敏感性表明，临床医生可以放心地使用当地实验室进行治疗前 HLA-B5701 筛查。但是，当地实验室必须参与 HLA-B5701 特异性质量保证计划，以保持 100%的敏感性。在 HIV 感染患者中，治疗前 HLA-B*5701 筛查可能有助于更明智地决定是否使用阿巴卡韦，并且有可能显著降低阿巴卡韦相关过敏反应的频率和管理这些反应的相关成本。
