Gao Shicheng, Gui Xi-En, Liang Ke, Liu Zhang, Hu Jinzhi, Dong Bo
Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
AIDS Res Hum Retroviruses. 2012 Jun;28(6):540-3. doi: 10.1089/AID.2011.0107. Epub 2011 Oct 19.
In this study, one hundred and three HIV-positive Chinese Han patients treated with a nevirapine (NVP)-based regimens were investigated for the association between nevirapine hypersensitivity reaction (NVP HSR) and human leukocyte antigen (HLA) allele. HLA-Cw, -DRB1 alleles were determined in 32 NVP HSR cases and 71 NVP-tolerant patients. We found that considerable overlap was observed for the clinical and demographic characteristics of the 32 hypersensitive patients and 71 tolerant patients. Twelve out of 32 NVP HSR cases developed allergic hepatotoxicity. More HLA-Cw04 alleles were observed in NVP HSR cases than in NVP-tolerant cases (p=0.029). The frequency of HLA-DRB115 in NVP-tolerant cases was significant higher than that in NVP HSR cases ( p=0.018). Multivariate logistic regression identified that HLA-Cw*04 presence was a risk factor related to NVP HSR (p=0.030, OR=3.611, 95% CI of OR: 1.135-11.489). To clearly understanding its value in clinical practice, further studies involving larger cohorts of patients from different races with different levels of immune suppression are needed.
在本研究中，对103例接受基于奈韦拉平（NVP）方案治疗的HIV阳性中国汉族患者进行了调查，以研究奈韦拉平超敏反应（NVP HSR）与人类白细胞抗原（HLA）等位基因之间的关联。在32例NVP HSR病例和71例对NVP耐受的患者中测定了HLA-Cw、-DRB1等位基因。我们发现，32例超敏患者和71例耐受患者的临床和人口统计学特征存在相当大的重叠。32例NVP HSR病例中有12例发生了过敏性肝毒性。与NVP耐受病例相比，NVP HSR病例中观察到更多的HLA-Cw04等位基因（p=0.029）。NVP耐受病例中HLA-DRB115的频率显著高于NVP HSR病例（p=0.018）。多因素逻辑回归分析确定，HLA-Cw*04的存在是与NVP HSR相关的危险因素（p=0.030，OR=3.611，OR的95%CI：1.135-11.489）。为了明确其在临床实践中的价值，需要对来自不同种族、免疫抑制水平不同的更大队列患者进行进一步研究。
