Prospective epidemiological study of the prevalence of human leukocyte antigen (HLA)-B5701 in HIV-1-infected UK subjects

Abstract

Objectives: Human leukocyte antigen (HLA)-B*5701 is strongly associated with developing a hypersensitivity reaction to abacavir (ABC) in White and Hispanic subjects. Across the UK, limited data exist on HLA-B*5701 prevalence in HIV-1-infected subjects. We determined HLA-B*5701 prevalence in the general HIV-1-infected population and in specific ethnic groups, particularly Black Africans who, in general, exhibit greater genetic diversity. We also compared HLA-B*5701 results obtained from local laboratories with those from a central provider. Design and methods: Multi-centre, observational study. All HIV-1-infected adult individuals receiving care at participating centres were eligible, irrespective of treatment status or prior exposure to ABC. Subjects provided samples for HLA-B*5701 assessment by both local (blood) and central laboratories (buccal swabs). HLA-B*5701 prevalence was adjusted to represent the ethnic group composition of the general UK population, and by main ethnic group. Results: From eight UK centres, 1494 subjects [618 (41%) White, 770 (52%) Black] were recruited. Eighty-nine per cent of Black subjects reported an immediate country of origin in Africa. Overall adjusted HLA-B*5701 prevalence was 4.55% [95% confidence interval (CI) 3.49% to 5.60%]. Among White subjects, prevalence was 7.93% (CI 5.80% to 10.06%). Among Black subjects, only two (both Ugandan) were HLA-B*5701 positive giving a rate of 0.26% (CI 0.07% to 0.94%). Conclusions: HLA-B*5701 prevalence was similar to previously reported rates in White HIV-infected subjects but considerably lower than that reported in Black HIV-1-infected subjects, as a result of the large proportion of Black African subjects. © 2009 British HIV Association.