Eighth International Congress on Drug Therapy in HIV Infection Glasgow, UK - 12-16 November 2006

Int Cong Drug Therapy HIV 2006 Nov 12-16;8:Abstract No. PL9.2

Laura Waters, Andrea Gritz, Desmond Maitland, Mark Nelson
St Stephen’s Centre, Chelsea & Westminster Hospital, London, UK

PURPOSE OF THE STUDY: To assess the clinical value of routine, prospective HLA-B5701 testing to reduce the prevalence of abacavir hypersensitivity (HSR) in a single-centre cohort of HIV-infected individuals.

METHODS: All individuals undergoing HLA testing since it became routinely available at our centre (August 2005) were identified. Demographic details were collected including sex and ethnicity. HLA results and subsequent antiretroviral prescribing were reviewed. Detailed notes review was carried out for all subjects with a documented adverse drug reaction or change of therapy.

SUMMARY OF RESULTS: Between August 2005 and July 2006 741 individuals have undergone successful HLA testing; 4 tests failed (4/741=0.005%). 54/741 tested HLA+ (7.3%); of 130 black patients 10 had a positive HLA result (7.7%). Of the 54 HLA+ subjects 14 remain treatment-naïve. 8/40 had a history of ABC exposure prior to HLA testing. 6/40 had a history of symptoms compatible with HSR; 2 had previous ABC, for 6 weeks and 5 years respectively, with no symptoms of intolerance. 564/741 patients were already on, or subsequently commenced antiretrovirals and 224 of these received ABC. 23/224 discontinued ABC. 7/23 tested HLA+ after commencing ABC. 16/23 were HLA negative; 4/16 had symptoms suggestive of ABC HSR, 3 underwent skin patch testing with 1 exhibiting a positive skin reaction. The remaining 12/16 had non-specific symptoms or symptoms felt not to be secondary to HSR. The rate of discontinuation secondary to typical HSR was 4/224 (1.8%).

CONCLUSIONS: Prospective HLA-B5701 testing has proven to be useful in reducing the rate of ABC discontinuation secondary to suspected HSR; historically approximately 7% have discontinued therapy for possible HSR reduced to 1.8% since the introduction of prospective HLA testing. Our results highlight the necessity for maintaining clinical suspicion despite negative HLA testing.

Plenary Session: Adverse Events I

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2006-11-12
PL9.2

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