12th Annual Conference of the British HIV Association 29 March–1 April 2006, Brighton, UK

CLINICAL UTILITY OF HLA-B*5701 TESTING IN A UK CLINIC COHORT

HIV Med 2006; 7(Suppl. 1):5 (abstract no. O19)

Iain Reeves, Duncan Churchill and Martin Fisher
Brighton and Sussex University NHS Trust, Brighton, UK

AIMS: To determine whether pre-treatment genotyping for HLA-B*5701 reduces the frequency of hypersensitivity reactions (HSRs) in patients commencing abacavir (ABC).

METHODS: A prospective study of B*5701 testing in patients starting or switching HAART. ABC was avoided in those testing positive for B*5701 and HSR rates monitored. The proportion experiencing an HSR was compared with that in patients starting ABC prior to B*5701 testing (Fisher’s exact test).

RESULTS: A total of 271 patients was tested and 26 (10%) were positive. Gender/ethnicity were as follows: males = 249 (92%), females = 22 (8%); black = 42 (15%), white = 215 (79%), other ethnicity = 11 (4%), not known = 3 (1%). The carriage rate was 23/215 = 11% in whites and 3/ 42 = 7% in blacks. 106 patients were treatment-naïve or on a treatment interruption; 165 were considering switching (135 of the latter were on a thymidine analogue). 81 patients subsequently started abacavir with an HSR rate of 0 (95% CI 0–4.6%) compared to 20/322 = 6% (95% CI 4.1–9.4%) HSR rate prior to B*5701 testing (P=0.01).

CONCLUSION: This is one of the first studies to report on B*5701 carriage rate in a UK-based clinical cohort. Testing for B*5701 significantly reduced the frequency of HSR. Incorporating this strategy into routine clinical practice is likely to lead to significant improvements in patient safety and counter the long-term toxicity of HAART.

2006-03-29
O19

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