HLA-B*57:01 allele prevalence in treatment-Na\xefve HIV-infected patients from Colombia

Ernesto Martínez Buitrago,William Lenis,Jorge Álvarez,Luisa Consuelo Rubiano,Luz Marina Sañudo,José Fernando García-Goez,José Millán Oñate

doi:10.1186/s12879-019-4415-3

Abstract

BackgroundThe HLA-B*57:01 allele is associated with a hypersensitivity reaction to abacavir. Due to the lack of knowledge of HLA-B*57:01 prevalence in Colombia, routine screening is not performed and is not recommended by the national guidelines. We aimed to determine the prevalence of HLA-B*57:01 in HIV population from Colombia.MethodsThis cross-sectional study included naïve HIV-infected adults from 13 cities of the country. The presence of HLA-B*57:01 was determined by using SSP-PCR in blood samples. Prevalence rates were stratified by sex, race, and region of origin.ResultsHLA-B*57:01 allele prevalence in Colombian HIV-infected individuals was 2.7%. When stratifying for the race, the prevalence was 4% for whites, 2.6% for other race (mainly mestizo), and 1.9% for Afro-Colombians. The prevalence varied from 0% up to 11.4% depending on the department of origin. The highest prevalence rates were found in Caldas (11.4%), Antioquia (5%), Risaralda (4.8%), and Valle del Cauca (4.3%). When distributed by country zones, the central, with a racial predominance of Caucasians and mestizos, was the highest (6.0%, 0R = 4.1, CI 1.2–12.8, p = 0,016).ConclusionsThe overall prevalence of HLA-B*57:01 in Colombia was lower than the reported rates for other Latin American countries such as Brazil, Costa Rica, and Argentina, but similar in comparison to Chile and Mexico. The diversity in the racial and ethnic heritage shown in our data supports the recommendation to implement routine screening for the HLA-B*57:01 allele before initiation of abacavir-containing antiretroviral therapy in the Colombian HIV management guidelines.

Highlights

The human leukocyte antigen (HLA)-B*57:01 allele is associated with a hypersensitivity reaction to abacavir
These cities have a population of diverse racial background and accounted for around 80% of the human immunodeficiency virus (HIV) population according to data from the Colombian non-governmental organization Cuenta de Alto Costo (CAC) [28]
HLA-B*57:01 is a genetic marker of clinical importance that has been successfully used in several other countries, resulting in a significant decrease of abacavir-related hypersensitivity reaction (HSR) (56–100%) [14,15,16,17, 33, 34]

Summary

Introduction

The HLA-B*57:01 allele is associated with a hypersensitivity reaction to abacavir. Due to the lack of knowledge of HLA-B*57:01 prevalence in Colombia, routine screening is not performed and is not recommended by the national guidelines. A nucleoside reverse transcriptase inhibitor (NRTI), is an antiretroviral agent frequently used as part of combination therapy for human immunodeficiency virus (HIV) infection. It is part of the first-line treatment regimens in HIV guidelines worldwide [1,2,3]. In 2008, the PREDICT-1 study demonstrated the effectiveness of prospective HLA-B*57:01 screening in preventing abacavir-related HSR, with positive and negative predictive values of 58 and 100%, respectively [14]. Current international HIV treatment guidelines recommend HLA-B*57: 01 screening in HIV-infected patients at diagnosis or before initiating abacavir-containing regimens if previously unknown. The occurrence of abacavir-related HSR has been reduced to 0–3% due to the exclusion of abacavir use in high-risk population [6, 14,15,16,17,18]

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