Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, California, USA.
Pharmacotherapy. 2013 Jul;33(7):765-75. doi: 10.1002/phar.1278. Epub 2013 May 3.
Abacavir is a nucleoside analogue reverse transcriptase inhibitor indicated for the treatment of human immunodeficiency virus infection as part of a multidrug, highly active antiretroviral therapy regimen. Despite its efficacy, approximately 5% of individuals who receive abacavir develop an immune-mediated hypersensitivity reaction (HSR) that warrants immediate discontinuation of abacavir and switching to an alternative antiretroviral regimen. Abacavir HSR is associated with individuals who carry the 57:01 variant in the human leukocyte antigen B (HLA-B) gene. There is a large volume of evidence to show that those who carry HLA-B57:01 are at significantly increased risk of developing HSR and should not receive abacavir. Pharmacogenetic screening to ensure individuals who carry HLA-B*57:01 do not receive abacavir can reduce the incidence of HSR and is now considered the standard of care before prescribing abacavir. Genetic testing to prevent abacavir HSR is currently one of the best examples of integrating pharmacogenetic testing into clinical practice.
阿巴卡韦是一种核苷类似物逆转录酶抑制剂，适用于作为多种药物、高效抗逆转录病毒治疗方案的一部分，治疗人类免疫缺陷病毒感染。尽管其有效，但约有 5%接受阿巴卡韦治疗的个体出现免疫介导的超敏反应（HSR），需要立即停用阿巴卡韦并改用替代抗逆转录病毒方案。阿巴卡韦 HSR 与携带人类白细胞抗原 B（HLA-B）基因中57:01 变体的个体有关。有大量证据表明，携带 HLA-B57:01 的个体发生 HSR 的风险显著增加，不应接受阿巴卡韦治疗。为确保携带 HLA-B*57:01 的个体不接受阿巴卡韦而进行药物遗传学筛查，可以降低 HSR 的发生率，目前被认为是在开阿巴卡韦之前的标准护理措施。预防阿巴卡韦 HSR 的基因检测目前是将药物遗传学检测整合到临床实践中的最佳范例之一。
