Tangamornsuksan Wimonchat, Lohitnavy Ornrat, Kongkaew Chuenjid, Chaiyakunapruk Nathorn, Reisfeld Brad, Scholfield Norman Charles, Lohitnavy Manupat
Center of Excellence for Environmental Health & Toxicology; Pharmacokinetic Research Unit; Department of Pharmacy Practice.
J Pharm Pharm Sci. 2015;18(1):68-76. doi: 10.18433/j39s3t.
This study aimed to systematically review and quantitatively synthesize the association between HLA-B*5701 and abacavir-induced hypersensitivity reaction (ABC-HSR).
We searched for studies that investigated the association between HLA-B genotype and ABC-HSR and provided information about the frequency of carriers of HLA-B genotypes among cases and controls. We then performed a meta-analysis with a random-effects model to pool the data and to investigate the sources of heterogeneity.
From 1,026 articles identified, ten studies were included. Five using clinical manifestation as their diagnostic criteria, 409 and 1,883 subjects were included as cases and controls. Overall OR was 23.6 (95% CI = 15.4 - 36.3). Whereas, the another five studies using confirmed immunologic test as their diagnostic criteria, 110 and 1,968 subjects were included as cases and controls, respectively. The association of ABC-HSR was strong in this populations with HLA-B*5701. Overall OR was 1,056.2 (95% CI = 345.0 - 3,233.3).
Using meta-analysis technique, the association between HLA-B5701 and ABC-HSR is strong in the studies using immunologic confirmation to identify ABC-HSR. These results support the US FDA recommendations for screening HLA-B5701 allele before initiating abacavir therapy.
本研究旨在系统评价并定量综合分析HLA - B*5701与阿巴卡韦诱导的超敏反应（ABC - HSR）之间的关联。
我们检索了调查HLA - B基因型与ABC - HSR之间关联并提供病例组和对照组中HLA - B基因型携带者频率信息的研究。然后我们采用随机效应模型进行荟萃分析以汇总数据并探究异质性来源。
从检索到的1026篇文章中，纳入了10项研究。其中5项研究使用临床表现作为诊断标准，纳入409例病例和1883例对照。总体比值比（OR）为23.6（95%置信区间[CI] = 15.4 - 36.3）。而另外5项研究使用确诊的免疫检测作为诊断标准，分别纳入110例病例和1968例对照。在该人群中，HLA - B*5701与ABC - HSR的关联很强。总体OR为1056.2（95% CI = 345.0 - 3233.3）。
采用荟萃分析技术，在使用免疫确认来识别ABC - HSR的研究中，HLA - B5701与ABC - HSR之间的关联很强。这些结果支持美国食品药品监督管理局（US FDA）在开始阿巴卡韦治疗前筛查HLA - B5701等位基因的建议。
