1. Successful implementation of a national HLA-B*5701 genetic testing service in Canada
- Author
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Jonathan B. Angel, Michael Gill, Richard G. Lalonde, Anita Rachlis, Niamh Higgins, Michel Roger, R. C. Thomas, George Davey Smith, and Benoit Trottier
- Subjects
medicine.medical_specialty ,Canada ,Anti-HIV Agents ,Cost-Benefit Analysis ,Immunology ,HIV Infections ,Human leukocyte antigen ,Biochemistry ,Drug Hypersensitivity ,Pharmacotherapy ,Abacavir ,Internal medicine ,Genetics ,medicine ,Immunology and Allergy ,Humans ,Genetic Testing ,Adverse effect ,Alleles ,Genetic testing ,Randomized Controlled Trials as Topic ,medicine.diagnostic_test ,business.industry ,virus diseases ,General Medicine ,Antiretroviral therapy ,Dideoxynucleosides ,HLA-B Antigens ,Reverse Transcriptase Inhibitors ,business ,Pharmacogenetics ,medicine.drug ,Hla b 5701 - Abstract
Abacavir is a nucleoside reverse transcriptase inhibitor (NRTI) that is used in combination antiretroviral therapy in HIV-infected patients. It is currently recommended as a preferred or an alternative NRTI in antiretroviral-naive patients. The major toxicity of abacavir is a hypersensitivity reaction (HSR), which occurs in approximately 5% of treated patients. There is a strong association between the human leukocyte antigen (HLA)-B*5701 allele and abacavir HSR, which has allowed for rapid acceptance of genetic screening for HLA-B*5701 in clinical use. Canadian clinicians working in hospital centers with HLA typing capacity opted to launch a pilot project in 2006 to offer the screening test as standard of care to HIV-infected patients. Currently, more than 11,000 HLA-B*5701 tests have been performed, among which 6.3% are positive. Continued efforts have been made to ensure that testing is available to all HIV-infected patients to widen the patients' therapeutic options. HLA-B*5701 screening shows clinical use and preliminary data suggest cost-effectiveness.
- Published
- 2009