Prevalence of Human Leukocyte Antigen HLA-B*5701 in HIV-1 Infected Individuals in Brazil

Abstract

This study was designed to establish the prevalence of HLA-B*5701 at HIV-1 infected individuals in Brazil. A total of 517 consecutive individuals were followed in this study from February 2009 through July 2011. The presence of HLA-B*5701 was determined by Nested-PCR with HLA-B*57 and HLA-B*5701 sequence-specific primers (PCR-SSP). The expression of HLA-B*57 was negative in the 385 (74.5%) and positive in the 103 (19.9%) of infected individuals. Among these, the expression of HLA-B5701 was positive in the 29 (5.6%) of individuals. No demographic or ethnic differences were found between HLA-B*57/HLA-B*5701 HIV-1 negative patients, with a prevalence of Caucasians (57.1%) individuals. During the period of study, 68 patients were submited to an abacavir containing regimen. The HLA-B*5701 allele was observed in 7 (10.3%) patients, with a significant incidence of Hypersensitivity reactions at 4 of them (p < 0.001). Conclusions: Although Brazilian population consists of a mixture of individuals of Caucasian, African and Native American genetic background, prevalence of HLA-B*5701 in this population is similar to the one found in pure Caucasians.

HLA-B*5701 Allele Prevalence in Treatment-Naïve HIV-Infected Patients from Colombia

“…We estimated an overall HLA-B*5701 prevalence rate of 2.7%, being lower than the reported rates for other Latin American countries such as Brazil (3.1-5.6%) 12,26 , Costa Rica (5%), 25 and Argentina (4.9%), 27 but higher in comparison to Chile (2.2%) 23 and Mexico (2%) 24 . The heterogeneity in HLA-B*5701 frequency underscores the need for local studies in countries, especially those belonging to such a genetically diverse region like Latin America, as even populations with similar ancestry backgrounds might differ significantly.…”

“…Several studies elsewhere have reported HLA-B*5701 prevalence rates from 0.3% to 7.7%, with most of them recommending screening in HIVinfected patients before using abacavir (Table 3). 12,14,15,18,[21][22][23][24][25][26][27] Remarkably, it must be noted that HLA-B*5701 screening, although highly specific, never substitutes for clinical follow-up of patients starting abacavir-containing regimens. 19,34 Our study had a few limitations.…”

“…[9][10][11] Abacavir-related HSR had an incidence of about 5% (range 0-14%), and a mortality rate of 0.03% before the significant association with HLA-B*5701 was established, and pretreatment genetic screening was employed. 4,[8][9][10][12][13][14][15][16][17][18] In 2008, the PREDICT-1 study demonstrated the effectiveness of prospective HLA-B*5701 screening in preventing abacavir-related HSR, with positive and negative predictive values of 58% and 100%, respectively. 14 Since then, current international HIV treatment guidelines recommend HLA-B*5701 screening in HIV-infected patients at diagnosis or before initiating abacavir-containing regimens if previously unknown.…”

“…6,[14][15][16][17][18][19][20][21][22] In Latin America, a few studies performed in Argentina, Brazil, Chile, Costa Rica, and Mexico have estimated the prevalence of HLA-B*5701 allele between 2 and 5.6% among HIV-infected patients. 12,[23][24][25][26][27] In Colombia, however, there are no data regarding the prevalence of HLA-B*5701 allele, and current national guidelines do not consider HLA-B*5701 screening in HIV-infected patients. 3 Colombia is a country with marked racial and ethnic differences across its geography making challenging to estimate the allele prevalence based on neighboring countries reports from the region leading this to uncertainty in the safety of the use of abacavir.…”

HLA-B*5701 Allele Prevalence in Treatment-Naïve HIV-Infected Patients from Colombia

“…[9][10][11] Abacavir-related HSR had an incidence of about 5% (range 0-14%), and a mortality rate of 0.03% before the significant association with HLA-B*57:01 was established, and pretreatment genetic screening was employed. 4,[8][9][10][12][13][14][15][16][17][18] 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 Since then, 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.…”