High Frequency of Human Leukocyte Antigen-B∗57:01 Allele Carriers among HIV-Infected Patients in Serbia

Abstract

Abacavir is an effective antiretroviral drug and one of the most commonly used nucleoside reverse transcriptase inhibitors in Serbia. A percentage of the treated patients experience a potentially life-threatening hypersensitivity reaction, which was shown to be associated with the presence of the class I MHC allele, HLA-B∗57:01; hence genotyping for HLA-B∗57:01 prior to starting abacavir is nowadays recommended in international HIV treatment guidelines. In Serbia, this testing became available in 2013. This study was designed to estimate the prevalence of the HLA-B∗57:01 allele in Serbian HIV-1-infected patients. The presence of the HLA-B∗57:01 allele was analyzed in 273 HIV-1-infected patients aged 18 years or more, who were abacavir naïve. Buccal swab samples were obtained from all participants and assayed for the presence of HLA-B∗57:01 using a commercially available HLA-B∗57:01 real-time PCR kit. The presence of the HLA-B∗57:01 allele was found in 22 of 273 tested individuals (8%; 95% CI 5.4-11.9%). This is the first study that estimated the HLA-B∗57:01 prevalence among HIV-infected patients in Serbia. The very high prevalence of HLA-B∗57:01 found in our study strongly supports HLA-B∗57:01 genotyping, which should be implemented prior to the initiation of an abacavir-containing therapy to reduce the risk of potentially life-threatening hypersensitivity reactions.