Journal article
Association of the HLA-B*53:01 Allele With Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome During Treatment of HIV Infection With Raltegravir
Clinical Infectious Diseases, Vol.64(9), pp.1198-1203
2017
Abstract
Background.
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare, severe adverse event during treatment with raltegravir. The occurrence of DRESS syndrome during treatment with other drugs is strongly associated with particular HLA alleles.
Methods.
We performed HLA testing in 3 of the 5 patients previously reported to have developed raltegravir-induced DRESS syndrome and in 1 previously unreported patient. We then used virtual modeling to visualize interactions between raltegravir and the imputed HLA molecule.
Results.
Five of the 6 patients who developed raltegravir-induced DRESS syndrome were African, and 1 was Hispanic. HLA typing was performed in 4 patients, all of whom carried both the HLA-B*53 allele and the HLA-C*04 allele to which it is commonly haplotypic. No other HLA alleles were shared by all of the tested patients. Given the approximate prevalence of HLA-B*53 carriage in African (20%) and Hispanic (6%) populations, the probability of all 4 patients being HLA-B*53 carriers, and 2 of 3 African patients being homozygous for HLA-B*53:01, is approximately 0.00002.
Conclusions.
These data implicate the prevalent African allele HLA-B*53:01 in the immunopathogenesis of raltegravir-induced DRESS syndrome. Although the immunopathogenic mechanisms are currently unknown, virtual modeling suggests that raltegravir may bind within the antigen binding cleft of the HLA-B*53:01 molecule, but not within the closely related HLA-B*35:01 molecule. Further studies are necessary to confirm the strength of the association between carriage of the HLA-B*53:01 allele and raltegravir-induced DRESS syndrome, and the potential utility of HLA screening before raltegravir treatment.
Details
- Title
- Association of the HLA-B*53:01 Allele With Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome During Treatment of HIV Infection With Raltegravir
- Authors/Creators
- M. Thomas (Author/Creator) - University of AucklandC. Hopkins (Author/Creator) - Auckland City HospitalE. Duffy (Author/Creator) - Auckland City HospitalD. Lee (Author/Creator) - University of California San DiegoP. Loulergue (Author/Creator) - Hôpital CochinD. Ripamonti (Author/Creator) - Ospedale Papa Giovanni XXIIID.A. Ostrov (Author/Creator) - University of FloridaE. Phillips (Author/Creator) - Vanderbilt University
- Publication Details
- Clinical Infectious Diseases, Vol.64(9), pp.1198-1203
- Publisher
- Published by Oxford University Press for the Infectious Diseases Society of America
- Identifiers
- 991005540012307891
- Copyright
- © The Author 2017.
- Murdoch Affiliation
- Institute for Immunology and Infectious Diseases
- Language
- English
- Resource Type
- Journal article
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- 1 Clinical & Life Sciences
- 1.265 Dermatology - Skin Allergies
- 1.265.1140 Drug Hypersensitivity
- Web Of Science research areas
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